Workers Compensation Claims Manager

Description

• Maintain diary for open claims and document specific claim related activities in Risk Management information system.
• Facilitate proactive identification of claims with opportunities for early Return to Work and light duty Return to Work program, as needed.
• Maintain and foster relationships with carriers and TPAs claims teams.
• Oversee assigned workers’ compensation case portfolio of minor to complex claims in assigned geographic region.
• Assist with claim data analysis and claim performance reports.
• Participate in CCIP kickoff meetings and jobsite walkthroughs, attend Claims, Safety and Operations meetings to monitor current and anticipated project risks and report on claims status for specific projects.
• Attend hearings and mediations on as needed basis.
• Participate in claims review process and monitor claims handling process by carriers and TPAs; provide direction to ensure compliance with best practices and special handling instructions.
• Partner with Safety team and onsite medics on initiatives that support worker wellness and post-injury care.
• Work with carriers, TPAs, and Defense Counsel to develop mitigation strategies for Owner Controlled Insurance Program (OCIP) that result in cost savings to the claim, ensure aggressive strategy is developed on litigated claims, and bring claims to timely resolution.
• Collaborate closely with Risk Management leadership on workers’ compensation claims, process, and procedures to ensure integrated program.
• Ensure avenues for potential claim recovery are identified and pursued and manage lien recovery on case-by-case basis.
• Collaborate with General Liability team to develop mitigation strategies and facilitate most economic global resolution of Contractor Controlled Insurance Program (CCIP) claims.
• Serve as resource for injured employees and inform of workers’ compensation process and procedures.
• Oversee and hold vendors and defense firms accountable for adherence to standard protocols, agreed to service instructions, and litigation management guidelines. Update instructions and guidelines and provide recommendations to appropriate leadership.
• Collaborate with HR and Payroll departments for completion of required Workers’ Compensation Jurisdictional Forms.
• Evaluate and respond to Reserve and Settlement Consultations within given authority, escalate consultations above scope authority to appropriate leadership.
• Report workers’ compensation claims to carriers and Third-Party Administrators (TPAs), including notification of questionable claims.
• Support audits related to workers’ compensation claims.
• Remain current on Workers’ Compensation laws and regulations, industry trends, and case law within assigned jurisdictions.

Requirements

• Professional written and verbal communication, and effective presentation skills
• OSHA (Occupational Safety and Health Act) knowledge and experience desired; OSHA 30-hour certification, a plus
• Bachelor Degree in Insurance, Risk Management, Finance, Business Administration or related program; with minimum of 8 years of workers’ compensation claims administration experience; or equivalent combination of education, training, and/or experience
• Self-starter with strong project management skills and capable of managing concurrent complex projects and tasks successfully to completion
• Experience with workers’ compensation claims in a construction environment, desired
• CRIS, ARM or similar insurance designation, desired
• Demonstrate process thinking and sound decision-making skills
• Leverage knowledge of workers’ compensation policy and manage incidents, and dispatch nurse case managers as necessary.
• Demonstrate strong interpersonal and teamwork skills with ability to work with individuals across organizational levels, both internal and external
• In-depth knowledge of workers’ compensation claims, medical management procedures, medical cost containment programs and applicable laws and regulations
• Analytical and adept at processing and breaking down data into actionable information
• Proficient computer skills, Microsoft Office suite of applications, and insurance-based risk management information systems
• Knowledge of jurisdictional laws and regulations for assigned territory

Benefits

• Limited travel

Training + Development

Interview process

Visa Sponsorship

Security clearance