SUMMARY
Provides leadership for a regional workers' compensation claims organization in
accordance with claims adjudication and benefit allocation. Responsible for the
overall performance of claims operations, including claim quality, customer
experience, workforce development, financial stewardship, regulatory compliance,
and operational effectiveness. Leads claim professionals, and support staff in
achieving organizational goals while promoting a culture of accountability,
continuous improvement, collaboration, and service excellence.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be
assigned.
1. Manages monoline workers' compensation unit of claim professionals and
support staff.
2. Leads claim team in support of department initiatives and strategies in cost
containment, case file handling, customer service and quality.
Consistently monitors workflows to maximize accuracy and efficiency.
Maintains an acceptable level of service and customer satisfaction and
retention.
Effectively manages the quality review process.
Develops unit goals, objectives, processes, procedures and systems.
Stays abreast of changes in workers’ compensation statutes, case law and
rehabilitation advancements.
Identifies team staffing needs and takes necessary measures to ensure
appropriate levels of service.
Mentors employees and develops career paths with growth opportunities.
3. Participates in development of annual departmental budget, monitors budget
and identifies budget discrepancies. Researches cause of discrepancies and
makes recommendations.
4. Participates in special projects and serves on committees as needed.
EDUCATION AND EXPERIENCE
Relevant combination of education and experience may be considered in lieu of
degree.
Bachelor’s degree in a related field.
Seven (7) years of experience in a claim environment with demonstrated
technical experience that provides the necessary knowledge, skills and
abilities.
Three (3) years of supervisory or leadership experience in claims required.
Previous workers’ compensation claim management with multi-jurisdictional
experience preferred.
Bilingual skills preferred.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each
essential duty satisfactorily. The requirements listed below are representative
of the knowledge, skill, and/or ability required. Reasonable accommodation may
be made to enable individuals with disabilities to perform the essential
functions.
OTHER SKILLS AND ABILITIES
Knowledge of team building and employee motivation theories with the ability
to effectively manage multi-functional employee teams.
Demonstrated leadership abilities.
Knowledge of laws, regulations and compliance requirements related to
workers’ compensation insurance.
Demonstrated technical knowledge of insurance administration, claims
management or relevant insurance expertise.
Ability to work with and empower others on a collaborative basis to ensure
success of unit team.
Excellent oral and written communication skills.
Knowledge of insurance and underwriting techniques, agency and policyholder
needs.
Ability to effectively present budgetary and/or cost information and respond
to questions as appropriate.
Ability to establish workflows, manage multiple projects and meet necessary
deadlines.
Ability and proficiency in the use of computers and company standard software
specific to position.
SUPERVISORY RESPONSIBILITIES
Directly supervises a varied number of employees in the designated
department(s). Carries out supervisory responsibilities in accordance with the
organization's policies and applicable laws. Responsibilities include
interviewing, hiring and training employees; planning, assigning and directing
work; appraising performance; rewarding and disciplining employees; addressing
complaints and resolving problems.
ADDITIONAL INFORMATION
The above statements are intended to describe the general nature and level of
work being performed by people assigned to this classification. They are not
intended to be construed as an exhaustive list of all responsibilities, duties
and skills required of personnel so classified. This job description does not
constitute a contract for employment.
WORKING CONDITIONS
Work is performed in a virtual office with no unusual hazards. Travel is
required, with some occasional overnight stays. Must possess a valid driver's
license with a record that meets corporate standards. Must be able to meet
general physical requirements that would allow the ability to view and
participate in account operations which may include climbing ladders and
scaffolding, work in confined spaces, and or other similar situations.
Pay Range - Actual compensation decision relies on the consideration of internal
equity, candidate’s skills and professional experience, geographic location,
market, and other potential factors. It is not standard practice for an offer to
be at or near the top of the range, and therefore a reasonable estimate for this
role is between $100,000 and $158,350.
The qualifications listed above are intended to represent the minimum education,
experience, skills, knowledge and ability levels associated with performing the
duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. We will not tolerate discrimination or
harassment in any form. Candidates for the position stated above are hired on an
"at will" basis. Nothing herein is intended to create a contract.
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