Manager, Patient Claims
Austin, TX - USA
Job Summary
JOB DESCRIPTION:
Working at Abbott
At Abbott you can do work that matters grow and learn care for yourself and your family be your true self and live a full have access to:
- Career development with an international company where you can grow the career you dream of.
- Employees can qualify forfree medical coverage in ourHealth Investment Plan (HIP) PPOmedical plan in the next calendar year.
- An excellent retirement savings plan with a high employer contribution
- Tuition reimbursement theFreedom 2 Savestudent debt program andFreeUeducation benefit - an affordable and convenient path to getting a bachelors degree.
- A company recognized asa great placeto work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
- A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity working mothers female executives and scientists.
The Opportunity
Abbott is seeking an experienced professional to manage patient claims related to its Medical Device businesses. This role leads day-to-day claim adjudication drives compliant consistent claim resolution and plays a critical role in protecting Abbotts legal regulatory financial and reputational interests.
This position works out of our Sylmar CA; Minneapolis MN; or Austin TX corporate office.
WhatYoullWork On
The Manager performs the following responsibilities with general direction from Legal leadership:
Claim Intake and Triage
- Direct and manage the complete lifecycle of U.S. patient product liability claims where the claimant is not represented by counsel encompassing claim intake investigation evaluation negotiation and resolution.
- Communicate with claimants on claim intake provide updates request necessary consents and documents and deliver decisions while maintaining a professional and empathetic tone.
- Ensure proper escalation of matters presenting regulatory litigation or safety risk.
Investigation and Evaluation
- Execute comprehensive investigations of medical records operative notes product history complaint data field reports and physician/hospital information to determine causation product involvement and claim valuation.
- Assess potential exposure and develop recommendations aligned with established precedent and organizational risk tolerance.
Claim Resolution
- Manage timelines resources and cross-functional workflows to ensure timely resolution regulatory compliance and alignment with organizational objectives.
- Negotiate settlements within designated authority levels; escalate novel complex or high-exposure matters to Legal leadership for strategic guidance.
- Deliver claim decisions in a professional and empathetic manner.
Compliance Governance and Risk Management
- Ensure full compliance with FDA regulations U.S. privacy/HIPAA requirements anti-kickback statutes and Abbotts complaint reporting processes.
- Oversee CMS Medicare Secondary Payer Section 111 reporting for all applicable patient settlements ensuring complete timely and accurate Responsible Reporting Entity submissions.
- Maintain accurate comprehensive and audit-ready case files settlement documentation correspondence and system records.
Cross-Functional Leadership and Continuous Improvement
- Lead or contribute to medical device legal team projects including but not limited to process improvement initiatives system implementations policy development and special investigations requiring coordination across multiple stakeholders.
- Influence commercial teams through consultative engagement to ensure proper escalation protocols and compliant patient interactions.
- Contribute to tactical planning and execution for high-volume claim periods advisories/recalls and patient communications initiatives.
- Analyze industry and Abbott-specific claims to identify patterns and trends; recommend data-driven process enhancements and risk mitigation strategies and train stakeholders on best practices.
Position Requirements
- Ability to evaluate complex product claims and determine reasonable settlements.
- Ability to exercise sound judgment in ambiguous or highrisk situations including determining when matters require immediate Legal Regulatory Quality or Compliance escalation.
- Ability to communicate effectively and empathetically with patients (over the phone or through written correspondence) including in highemotion or adversarial situations while maintaining appropriate legal and regulatory boundaries.
- Knowledge of US privacy laws anti-kickback and medical device reporting.
- Demonstrated ability to work in fast-paced matrixed environment
- Excellent verbal and written communication skills.
- Strong organizational skills with attention to detail.
Minimum Required Qualifications
- Bachelors Degree
- 5 years product liability claims medical device legal operations insurance claims risk management or a closely related regulated environment.
- Experience evaluating and resolving medical technical or regulatory claims or issues.
Preferred Qualifications
- Experience in medical devices pharmaceuticals or other FDA-regulated industries
- Paralegal Certification preferred
- Strong investigative skills including medical record review
- Experience in CMS Section 111 reporting
- Learn more about our health and wellness benefits which provide the security to help you and your family live full lives:
- Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer committed to employee diversity.
- Connect with us at on Facebook at and on Twitter @AbbottNews.
The base pay for this position is
$129300.00 $258700.00In specific locations the pay range may vary from the range posted.
JOB FAMILY:
Operations & Business Support
DIVISION:
GENC General Counsel
LOCATION:
United States > Minnesota > Plymouth : 5050 Nathan Lane N
ADDITIONAL LOCATIONS:
United States > Austin : 8701 Bee Caves Rd United States > Sylmar : 15900 Valley View Court
WORK SHIFT:
Standard
TRAVEL:
Yes 5 % of the Time
MEDICAL SURVEILLANCE:
Not Applicable
SIGNIFICANT WORK ACTIVITIES:
Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day) Keyboard use (greater or equal to 50% of the workday)Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.
EEO is the Law link - English: EEO is the Law link - Espanol: Experience:
Manager
About Company
WHO WE ARE CREATING LIFE-CHANGING TECHNOLOGY From removing the regular pain of fingersticks as people manage their diabetes to connecting patients to doctors with real-time information monitoring their hearts, from easing chronic pain and movement disorders to testing half the world’s ... View more