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Claims Management Specialist

2 months ago


Greensboro, North Carolina, United States Stake Center Locating Full time
Job Overview

POSITION SUMMARY

The Claims Management Specialist role seeks a proactive, detail-oriented individual to support the Corporate Risk & Insurance Manager. This position serves as the primary contact for all workers' compensation claims, responsible for gathering investigation reports, medical documentation, and wage loss details, while submitting claims to the insurance provider as necessary. Additionally, this role assists with the Driver Qualification Program and the Compliance Analyst/Drug and Alcohol Program, collaborating with the Risk Manager to obtain essential case-related documents for ongoing legal matters.

KEY RESPONSIBILITIES

Core Duties and Expected Contributions

  • Act as the initial point of contact for all reported injuries and workers' compensation claims.
  • Review and document all reported injuries through the Medcor Injury Triage Assessment Service, determining whether claims should be managed internally or submitted to the insurance carrier.
  • Maintain and update workers' compensation files in the database, keeping the Risk Manager informed of any developments.
  • Facilitate the return-to-work process for injured employees through reasonable accommodation programs and medical case management.
  • Ensure that managers are informed of accommodation and work restrictions, adhering to restricted work duties and securing necessary Personnel Action Forms (PAFs).
  • Coordinate with Payroll to ensure timely provision of wage loss information to the adjuster.
  • Assist in managing in-house auto damage claims and assign auto claims to the insurance carrier as required.
  • Conduct thorough subrogation investigations and ensure timely completion of all claims with recovery potential, maintaining a spreadsheet for quarterly review.
  • Support the Compliance Analyst/Drug and Alcohol Program as needed.
  • Assist with the Driver Qualification Program as required.
  • Oversee the company's random Drug and Alcohol Screening program.
  • Complete NCMS documentation accurately.
  • Assist the Risk Manager in gathering case-related documents.

Position Requirements:

A. Experience Required

  • Minimum of three (3) years of experience in claims management related to workers' compensation.
  • North Carolina adjuster license is preferred but not mandatory.
  • Familiarity with claims litigation processes.
  • Experience in communication and negotiation with insurance companies.
  • Knowledge of legal and medical terminology.
  • Strong organizational skills with the ability to manage multiple tasks effectively.
  • Excellent verbal and written communication skills.
  • Ability to handle confidential information with discretion.
  • Capability to build and maintain effective working relationships with management, employees, third-party administrators, insurance carriers, claims handlers, and legal counsel.

B. Functional Knowledge and Business Expertise Required

  • Demonstrates accountability for the timeliness and quality of work assignments.
  • Possesses strong written and verbal communication skills, with the ability to present recommendations clearly and concisely.
  • Able to manage multiple priorities while maintaining order and control.
  • Exhibits a strong work ethic.

C. Attributes/Competencies

  • Critical Thinking
  • Time Management
  • File Management
  • Investigation Skills
  • Strong Organizational Skills
  • Integrity and Trust
  • Discretion and Confidentiality
  • Interpersonal Savvy
  • Negotiating Skills

Stake Center Locating is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status, age, or any other federally protected class.