Manager, Workers' Compensation Claims and Compliance

3 days ago

Naperville, Illinois, United States Illinois Health and Hospital Association Full time

Main Function

Responsible for the management of lost time adjusting staff in the overall administration of the workers' compensation claims department and oversight of compliance functions.

Outline of Responsibilities

  • Assist the Assistant Vice President in the establishment and continual review of all policies, procedures and service products for the workers' compensation department.
  • Staff, manage and conduct performance appraisals for direct reports, and provide continual education to all staff members to ensure state of the art service to clients.
  • Assist department management with projects and program enhancements.
  • Provide reserve, settlement and payment authority. Maintain a continual diary system over all claims.
  • Provide management oversight of excess reporting of all claims. Provide oversight and management of claims involving excess carriers.
  • Oversee jurisdictional EDI reporting with emphasis on correction of errors and adjuster compliance and training.
  • Assist with oversight of Section 111 compliance. Participate in client visits during claim reviews.
  • Participate and provide educational assistance to all clients. Respond to service needs of all clients.
  • Assist in the development and management of components of the yearly symposium.
  • Assist in the audits from outside groups such as excess carriers.
  • Participate in all ICT administrative activities such as Board Meetings, Underwriting activities, etc. and represent Assistant Vice President, as needed.
  • Oversee management of cases that involve subrogation from start to finish, and train and mentor staff in the area of subrogation recovery.
  • Complete technical audits for all adjusting staff and mentor/train staff accordingly.
  • Develop and lead ongoing training program for adjusting staff.
  • Other duties as defined.

Qualifications

Bachelor's degree or combination of experience and/or certifications considered in lieu of education. Michigan adjusting license preferred or willingness to obtain within a year. At least five years of adjudicating and/or supervising indemnity workers' compensation claims experience required. EDI and Section 111 compliance and advanced subrogation experience preferred. Knowledge of Iowa, Illinois and Michigan jurisdictions preferred. Experience managing projects and/or solid organizational, critical thinking, and communication skills preferred. Excellent customer service skills as well as the ability to manage a high volume workload with efficiency and accuracy and delegate effectively to meet deadlines. Capable of maintaining a cohesive work environment throughout the department and develop, manage and motivate staff in the maintenance of a positive work environment. Must possess a strong attention to detail. Knowledge of Microsoft Office. Infrequent travel is required.

We offer a competitive salary with an excellent benefits package.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.

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