Workers' Compensation Claims Manager

4 weeks ago

Des Moines, United States Creative Risk Solutions Full time

We are looking to add an additional Workers' Compensation Claims Manager to join our team in Waukee, IA, to help manage our nationwide Workers’ Compensation Team As this department continues to grow, we have identified a need for an additional Manager Duties: Manages all workers compensation adjusters directly. Ensures their work product is top notch and meets the requirements specified in our best practices. Responsible for all staffing analysis, jurisdictional analysis, and staffing budget for workers compensation team. Mediates situations as they arise between the insured and the insurance company, to include researching coverage issues, large loss reporting, and all audit responses required. Troubleshoots complex claim issues and matters where attorney involvement requires higher level authority or interpretation. Finalizes all contracts with regard to any 3rd party services provided for workers compensation claims. Generates checks for indemnity and medical payments as a backup for adjusters as needed or required. Requests and interprets workers compensation reports on designated accounts, as requested, for agency, customers and fronting carriers. Meets with clients to discuss on-going claims or to review claim history, to include but not limited to: coverage issues, and answering client’s inquiries. Position will require handling of administrative duties of claim staff which may include hiring and firing. Participates in the CRS Leadership Committee to evaluate strategic direction of the company and develop new standards as needed. Assists in sales and account management as requested or needed by the account manager. Analyzes and implements requirements of state departments of insurance for TPA regulations. Supervises claim activity of captive claim handlers. Knowledge, Skills, and Abilities: Knowledge of workers’ compensation insurance coverage and the ability to apply that knowledge in the performance of the job duties. Skillful knowledge of claims processing procedures. Ability to work with persons under adverse or highly emotional conditions. Knowledge of organizational methods and the ability to manage multiple tasks/duties simultaneously. Ability to work daily and extended hours, as necessary. Ability to maintain confidentiality. Ability to act in a professional and courteous manner. Ability to learn various software programs. Must be knowledgeable of and comply with our Client Privacy Policy, HIPAA regulations and E&O procedures and policies. Qualifications: Education:A high school education or GED equivalent; college preferred. Industry specific technical designations (AIC, CIC, or ARM) Experience:Minimum of five years claims experience with strong background in Workers’ Compensation or Liability coverage and claim adjudication. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid parental leave and supportive new parent benefits — we know being a working parent is hard, and we want to support our employees in this journey Company paid continuing education & tuition reimbursement — we support those who want to develop and grow. 401k Profit Sharing — Each year, we make a lump sum contribution to every full-time employee’s 401k. This means, even if you’re not in a position to set money aside for the future at any point in time, we will do it on your behalf We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays — Yes, we actually encourage employees to use their time off, and they do. After all, you can’t be at your best for our clients if you’re not at your best for yourself first. Supportive of community efforts with paid volunteer time off and employee matching gifts to charities that are important to you — Through our foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs — we are committed to celebrating every employee’s unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid diversity day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish Consistent merit increase and promotion opportunities — Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important — not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity — Yes, there is an annual opportunity to make more money. Who doesn’t love that?

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