Workers' Compensation Claims Manager

7 days ago


Salem, Oregon, United States CCMSI Full time

As a leading Third Party Administrator in self-insurance services, CCMSI is dedicated to delivering exceptional service to our clients.

We are seeking an experienced Workers' Compensation Claims Supervisor to lead our team handling claims exclusively for a dedicated national retail client in Salem, OR.

In this role, you will oversee the investigation, adjustment, and supervision of workers' compensation claims, ensuring all claims are managed efficiently and in strict compliance with Oregon and Washington's workers' compensation laws.

You will be accountable for maintaining the highest standards of service quality, as perceived by our client, and for upholding CCMSI's corporate claim standards.

This position also serves as advanced training for those interested in progressing to a management role within CCMSI.

Key Responsibilities:

  • Supervise a team of adjusters, providing guidance and support to ensure accurate and timely resolution of Oregon and Washington workers' compensation claims.
  • Maintain strong client relationships, ensuring satisfaction and clear communication throughout the claims process.
  • Uphold CCMSI's corporate claim standards and ensure the quality of services delivered to our client.
  • Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.
  • Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.
  • Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
  • Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
  • Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
  • Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
  • Assist designated claim staff in the selection, referral and supervision of designated claim files sent to outside vendors.
  • Direct handling of designated litigated and complex claims.
  • Provide education, training and assist in the development of claim staff.
  • Review and maintain personal diary on claim system.
  • Supervision of all claim activity for specified accounts.
  • Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Requirements:

  • 10 + years claim experience is required.
  • Computer Skills: Proficient in Microsoft Office products such as Word, Excel, Outlook, etc.
  • Certificates, Licenses, Registrations: CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.


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