Workers' Compensation

5 days ago

Washington, United States The George Washington University Full time
Job Summary

The George Washington University is seeking a highly skilled Workers' Compensation & Liability Manager to join our team in the Office of Risk Management. As a key member of our team, you will be responsible for managing the District of Columbia Workers' Compensation claims, ensuring compliance with relevant laws and regulations, and providing detailed data analysis and reporting.

Key Responsibilities
  • Oversee workers' compensation claims from initial report to resolution, ensuring all necessary information is obtained for accurate processing.
  • Review claims for eligibility, completeness, and accuracy while handling routine and moderately complex claims, including some litigated ones with limited settlement authority.
  • Assist in managing other claims such as general liability, auto liability, and property to ensure a comprehensive approach to claims management.
  • Maintain updated records of all claims and prepare required reports. Perform the design, analysis, and delivery of claim information. Provide insights and recommendations to improve claims processing efficiency and cost control.
  • Contact individuals about claims and coordinate the handling of benefits. Communicate effectively with claimants, healthcare providers, and legal professionals. Coordinate with third party administrators (TPA), insurers, and legal professionals to manage claims effectively. Conduct interviews with injured employees, physicians, and witnesses for claims investigation.
  • Ensure compliance with domestic and international claim programs, policies, and procedures. Assist with litigation management, including reporting, investigation, and analysis. Assist with contract reviews focusing on insurance, liability, and indemnification provisions. Conduct compliance audits and ensure adherence to regulatory guidelines.
  • Assist with general risk management activities related to the university's projects and operations. Analyze potential risks in claims and develop strategies to mitigate these risks. Ensure that all risk management activities align with the university's financial operations and goals.
Requirements
  • Qualified candidates will hold a Bachelor's degree in an appropriate area of specialization plus 5 years of relevant professional experience, or a Master's degree or higher in a relevant area of study plus 3 years of relevant professional experience. Degree must be conferred by the start date of the position. Degree requirements may be substituted with an equivalent combination of education, training, and experience.
  • 3 years of responsible risk management experience directly applicable to Workers Compensation claims processing preferred. Professional certification (ARM or RIMS-CRMP) also preferred.
  • In-depth knowledge in the following areas:
    • Principles and practices of insurance claims examination
    • Collection and interpretation of data
    • DC Workers Compensation Act and its rules, regulations, forms, and procedures
    • Interviewing techniques
    • Medical terminology and treatment procedures
    • Claims management systems or database system
    • Enterprise financial systems
    • Excel and other spreadsheets
  • Ability to do the following:
    • Interpret and apply laws, rules, and regulations
    • Obtain and utilize sensitive information discreetly and objectively
    • Maintain records, prepare reports, and conduct correspondence related to the work
    • Communicate effectively with others (both verbal and written)
    • Maintain favorable public relations
    • Analyze data and prepare reports
    • Minimize risk exposures, identify risk transfer opportunities in contracts, and optimize vendor indemnification and insurance requirements

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