Workers Compensation Claims Manager Jobs in Georgia

Communicate with manager on claims above authority granted.

Participate in OR's Managed Care Excellence Group as requested.

Ensure TPA compliance with our best claim practices.

Provide direction to TPA as needed.

Act as liaison between insureds and TPA as needed.

Review/ approve reserves on assigned claims.

Manage existing workloads effectively to achieve quality and quantity production goals while providing superior customer service.

Control file-related expenses through efficient utilization and monitoring of "outside" vendors.

Inform other departments of positive/negative conditions noted during investigations which may impact company results.

Advising employers on the proper management and impact of Workers’ Compensation claims

Healthcare benefits begin on your first day of employment

Hybrid work schedule: Three days in the office, two days from home

The prompt provision of benefits and assistance in early return to work

Computer Literacy with strong Microsoft Office capabilities

Excellent communication and organizational skills

Strong people management skills, effective at coaching and motivating staff. Serves as a role model in building effective relationships

Manage according to established expense, reserve and settlement authority levels.

Bachelor's degree with related claims experience

Effectively and creatively utilizes all resources (systems, people, etc.) to manage daily operations

Possess advanced claims technical knowledge combined with the ability to teach

Supervisory experience preferred but not required

Execute on performance management; attract, hire, retain and provide high level of training

Collaborate with internal teams, such as Account Management, Compliance, and Claim Operations, to resolve complex or escalated claims-related issues

Passionate claims professional who cares about their team, the customer, and their experience

Develop and implement strategies to mitigate fraudulent claims and ensure compliance with legal and regulatory requirements

Bachelor's degree in insurance, business administration, or a related field; relevant certifications (e.g., CPCU, AIC) are a plus

Provide a manageable pending for you to deliver the service in a way you’ve always wanted and a dedicated account

Four (4) years of claims management experience or equivalent combination of education and experience required.

Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

Manages subrogation of claims and negotiates settlements.

Excellent oral and written communication, including presentation skills

Communicates claim action with claimant and client.

Organizational skills – attention to detail, time management, focus on priorities, thoroughness, follow up

Claims Trainees gain the skills & experience to succeed at:

Click Here to review our U.S. Eligibility Requirements

Learning to investigate claims with overall instruction, exposure and preparation

Analyzing & evaluating claims to make appropriate decisions & recommendations

Effectively communicating with clients and contacts