Workers Compensation Claims Manager Jobs in Union, Arkansas

Stay abreast of changes in compliance procedures and identify and communicate compliance process enhancement opportunities to management

Cultivate and maintain relationships with internal and external customers

Gather, analyze, and distribute compliance information to satisfy needs of business partners, and to facilitate appropriate outcomes

Complete assigned daily compliance support activities timely and accurately

Contribute assistance that enhances and enables achievement of compliance objectives by demonstrating teamwork and collaboration to elevate partner and customer service

Look for ways to improve compliance with state and federal laws and regulations

Partners with HR and management to ensure timely communication to associates to minimize business disruptions

Primary point of contact for team members and managers regarding on-the-job injuries

Ensures that the workers’ compensation program is managed in accordance with applicable OSHA and workers’ compensation laws and regulations

Collaborates with finance and leadership for setting and approval of reserves

Manages the alternate duty program, working with managers and team members to ensure program compliance

Maintains knowledge of all applicable workers’ compensation, leave and accommodation laws including the FMLA, ADA, and state and local laws

•Experience of 5 years of claims management experience or equivalent combination of education and experience required.

•Coordinates vendor referrals for additional investigation and/or litigation management.

•Refers cases as appropriate to supervisor and management.

•Analyze complex or technically difficult workers' compensation claims to determine benefits due.

•Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements.

•Manages the litigation process; ensures timely and cost effective claims resolution.

2- 5+ years of experience handling primarily Lost time claims.

Excellent Customer Service and Organizational skills

Flex schedule and ability to work remotely

Must Hold Active License in Fl, TX

$ 72,000 - $ 84,000 annual salary

Partner with Finance in the review of all compensation related changes in the company

Partner with global HRBP team and Managers on Compensation related matters

1-2 years people leadership experience

Comprehensive knowledge of compensation related laws and regulations

This position is open to remote employees -

Assist in the development of LM’s total rewards programs including compensation, incentive pay programs, stock and perks

Job Requirements (education, experience, skills):

College graduate and/or applicable insurance industry training and/or experience.

Exceptional oral, written, and interpersonal communication skills

Excellent customer service and negotiation skills

Strong organizational skills, attention to deal, and ability to multitask.

Knowledge of MS Office applications, related claims and business software

Submits severe incident reports, reinsurance reports and other information to home office, claims management, and underwriting.

3-5 years of works compensation, or work loss claims experience.

Demonstrated California Workers Compensation claims handling experience is required.

Prior insurance carrier experience is preferred.

Strong written & verbal communication skills.

Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers.

5 years of works compensation, or work loss claims experience.

Demonstrated California Workers Compensation claims handling experience is required.

Prior insurance carrier experience is preferred.

Strong written & verbal communication skills.

Conducts customer/account visits to review reserves and discuss status of significant claims. May also present educational workshops to client personnel.

The Nationwide Values at the forefront of their work.

1-3 years of works compensation, or work loss claims experience.

Prior insurance carrier experience is preferred.

Strong written & verbal communication skills.

The Nationwide Values at the forefront of their work.

Partners with Special Investigative Unit and Subrogation to identify fraud and subrogation opportunities.

· Exceptional project management skills

· Oversee the production and distribution of weekly, monthly and ad hoc senior management reports and presentations

· Promote effective communication among and between work groups and between management and employees.

· Excellent customer service and collaboration skills gained through previous work experience

· Excellent Excel and MS Access skills required; knowledge of HTML, SQL, VBA preferred

Experience with analytics in the commercial casualty insurance industry required.

Experience: Five (5) years of claims management experience or equivalent combination of education and experience required.

Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

Coordinates vendor referrals for additional investigation and/or litigation management.

Refers cases as appropriate to supervisor and management.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Five (5) years of claims management experience or equivalent combination of education and experience required

Coordinates vendor referrals for additional investigation and/or litigation management.

Refers cases as appropriate to supervisor and management.

SkillsQualifications: Bachelor's degree from an accredited college or university preferred

DescriptionDescription:Analyze complex or technically difficult workers' compensation claims to determine benefits due.

Manages the litigation process; ensures timely and cost effective claims resolution.

Experience applying laws, rules, regulations, policies, and procedures when reviewing claims for benefits

Experience adjudicating highly complex cases for benefits based on evidence.

Experience reviewing reconsideration requests or appeals for benefits.

Requires a probationary period if the requirement has not been met.

Experience making and issuing final decisions that affirm or remand cases for further development

Reviews claimant requests for reconsideration of final decisions with delegated authority to finalize or modify decisions of the initial claims examiner.

Provide WC claims’ management education and WC regulatory updates to local business units.

Bachelor’s degree in Risk Management, Finance or Nursing background preferred

Ability to effectively work and collaborate with people with a wide range of skills, experience, cultures, and capabilities

Other duties as directed by management

Minimum seven (7) years of experience managing WC claims

WC technical knowledge and WC case law in multiple jurisdictions from Ohio to California

C (Download PDF reader)lick here to view Minimum Qualification Specification (Download PDF reader)

Click here to view Minimum Qualification Specification (Download PDF reader)

o qualify, you must meet all of the following requirements:

Professional Trainee II: SR-18, Salary $4,339 per month

Professional Trainee I: SR-16, Salary $4,011 per month

Consideration may be given to lower levels:

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.

Provide WC claims’ management education and WC regulatory updates to local business units.

Bachelor’s degree in Risk Management, Finance or Nursing background preferred

Ability to effectively work and collaborate with people with a wide range of skills, experience, cultures, and capabilities

Other duties as directed by management

Minimum seven (7) years of experience managing WC claims

WC technical knowledge and WC case law in multiple jurisdictions from Ohio to California

Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.

Manages an inventory of workers compensation claims to evaluate compensability/liability.

Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.

Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.

Plans and conducts investigations of claims to confirm coverage and compensability.

Performs other duties as assigned.

If you are relying on your education to meet qualification requirements:

Prepares reports and provides data advising management of new trends in the hearing program.

Requires a probationary period if the requirement has not been met.

Drafting and/or signing final decisions or briefs to claimants who have applied for compensation benefits.

Analyze and interpret legal issue(s) to determine entitlement to workers' compensation benefits under federal laws.

You will be evaluated for this job based on how well you meet the qualifications above.

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.

Manage all aspects of claims to resolution in accordance with jurisdictional requirements

Obtain appropriate state adjuster certification and continuing education credits

Establish appropriate claim reserve and manage reserve adequacy throughout life of claim

Negotiate skillfully in difficult situations to win concessions without damaging relationships

Minimum 3 years progressive work experience in administrative role

Bachelor's Degree in relevant field or equivalent work experience