Sr Claims Specialist
Sr Claims Specialist
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
This is a remote position.
Job Title: Sr. Specialist Claims
Reports To: Director of Risk Management
Our client serves as a dedicated strategic partner to government and other clients. We seek to hire people who share our dedication to excellence our passion for the work and our commitment to a collaborative and inclusive work environment.
Summary:
The Sr. Specialist Claims is responsible for managing workers compensation claims activity from conception to resolution.
Essential Functions:
.
Manage Workers Compensation claims activity from conception to resolution performing technical analysis and take proactive steps to mitigate claim cost.
.
Maintain strong relationships with internal and external business partners.
.
Review approve or provide oversight of medical and miscellaneous invoices to determine if reasonable and related to designated claims.
.
Negotiate with medical providers and third parties on selfinsurance settlements.
.
Coordinates and participates in strategic planning aimed at identifying developing trends with respect to type of loss severity and frequency.
.
Communicates and interacts with medical professionals carriers operations and HR partners to monitor and assess the progress of rehabilitation efforts and to facilitate return to work.
.
Lead and mentor peers on various claims processes/tasks.
.
Work together with the Director of Corporate Insurance and Risk on other departmental and administrative duties as assigned.
.
Other duties as assigned.
Knowledge and Skills:
.
Proficient with Microsoft Office Suite.
.
Thorough knowledge of the Workers Compensation coverage and process.
.
Taking the initiative and being resourceful.
.
Ability to use independent judgment and make appropriate insurance claims adjustment decisions and determinations.
.
Excellent interpersonal communication skills.
.
Conflict resolution and/or mediation skills.
.
Ability to maintain confidentiality in matters involving personnel issues.
.
Analytical and problemsolving skills.
.
Attention to detail and ability to produce both standard and ad hoc reports.
.
Adaptable to new concerns and changing environments.
.
Ability to work flexible hours. We operate 24/7/365.
Requirements:
.
Bachelors degree in business administration risk management or a related field.
.
5 years of experience handling workers compensation claims
.
Workers Compensation Multijurisdiction selfinsured company and/or TPA and AIC or similar designation preferred.
.
Proven experience working in full collaboration across multiple disciplines both internal and external.
.
Bilingual (English/Spanish)
.
Must be authorized to work in the U.S. and able to travel within the Continental United States (CONUS).
.
Must pass a background check after accepting a conditional offer of employment.
Employment Type
Full Time
