Risk & Claims Operations Specialist

About the role

Jackson Healthcare and our family of companies provide healthcare systems, hospitals and medical facilities of all sizes with the skilled and specialized labor and technologies they need to deliver high quality patient care and achieve the best possible outcomes - while connecting healthcare professionals to the temporary engagements, contract assignments and permanent placement employment opportunities they desire. Headquartered in metro Atlanta, we're powered by more than 2,600 associates and over 20,000 clinician providers covering all 50 U.S. states. Our mission is to improve the delivery of patient care and the lives of everyone we touch. This includes the patients, clinicians and healthcare executives we work with through our companies every day, as well as our communities, the nonprofit organizations we support and each associate who is part of our family. We're always looking to add new talent to our teams. We value diverse professionals at all levels and across multiple disciplines and areas of expertise, who have strong leadership skills, align with our culture, and are committed to excellence. Position Overview The Risk & Claims Operations Specialist supports the daily operations of the Risk Management and Claims Management functions across the Jackson Healthcare enterprise. This is not a role for someone who is content with the status quo. We are looking for someone who asks "why do we do it this way?" - and then does something about it. Critically, this role operates through influence rather than authority. You will serve as a trusted partner to 22 distinct companies - building relationships, communicating value, and driving process alignment without a direct reporting line. The ability to earn trust, communicate clearly, and demonstrate consistent value is just as important as technical skill. The ideal candidate is deadline-driven, process-oriented, and technologically savvy, with the intellectual curiosity to challenge assumptions and the initiative to pursue simpler, smarter solutions. Advanced Excel skills, a strong sense of ownership, and genuine openness to emerging technologies - including AI-powered tools like Microsoft Copilot and Claude - are essential. If building better processes, working across a dynamic enterprise, and embracing innovation as a daily practice excites you, this role was designed with you in mind. Key Responsibilities Risk Review Operations Jackson Healthcare's core business is placing physicians, nurses, and other healthcare providers in clinical settings across the United States on a short-term basis. Each of the 22 Jackson companies sources and credentials these providers through a rigorous screening process. When a provider's background raises a potential concern - a licensing issue, a gap in history, a malpractice flag, or other credentialing exception - that file is escalated to the Risk team for deeper review. This role is the engine of that process. Manage the daily intake and completion of provider Risk Reviews within established deadlines Evaluate escalated provider files using Microsoft Teams, SharePoint, VComm, MDStaff, and Outlook, applying preestablished guidelines and criteria to assess flagged exceptions - clinical expertise is not required; sound judgment and process discipline are Investigate documentation thoroughly against defined standards, identifying and clearly articulating red flags in accordance with established protocols Prepare concise, well-organized summary reports in Microsoft Word documenting findings and risk considerations Assign the appropriate approval level to each provider file based on established criteria Record all Risk Review outcomes in the Risk Management Information System (Origami) Communicate findings and approval status to company representatives across the Jackson Healthcare family in a clear, timely, and professional manner Conduct annual audits comparing providers paid vs. Risk Reviews completed, analyzing year-over-year trends and reporting on gaps or process breakdowns Claims Verification Jackson Healthcare manages medical malpractice coverage for providers placed across its 22 companies. When those providers later apply for hospital privileges, institutions require a loss history verification - confirmation of whether any malpractice claims were filed during the provider's time with a Jackson company. Requests flow through an automated portal checked against the claims system, handling approximately 12,000 verifications annually. The vast majority are processed automatically; when a provider does have a claim on record, that exception is routed to this role for review and confirmation before a response is issued. Take a leadership role in overseeing the integrity and performance of the automated claims verification process Monitor exception queues and manage the review and confirmation of flagged claims before responses are issued Maintain organized, audit-ready records and ensure proc