Cash Applications Specialist

Kellermeyer Bergensons Services • Oceanside, CA

22h • $70 - $80 • Remote

About The Position

Manages severe loss claims within company standards and best practices. Processes workers compensation claims, conducting investigations and coordinating with carrier and internal legal team as appropriate. Reviews compensable issues and determines dispositions including continuance or denial of cases within scope of authority. Tracks and monitors claims occurrences. Identifies opportunities to address safety issues and provides recommendations based on supporting analysis of claims activity. Works to oversee claims across multiple verticals within the business.

Requirements

• 5-10 years direct experience managing workers compensation claims across for large companies managing claims associated with severe loss
• Claims management experience in industrial and or chemical cleaning, building and or landscaping where operation of equipment and proper handling of tools and chemicals is essential
• Microsoft Office programs to include, but not limited to Word, Excel, PowerPoint and Outlook
• Must be bilingual Spanish (able to read and write)
• Proficiency in OSHA General Industry standards, state safety statutes and local municipal regulations
• Safety program(s) development and delivery (training and communications)
• TPA and other insurance program coordination
• Industry specific safety training; chemicals, equipment use and repairs, procedures for performing labor and related safety measures
• Data review and analyses
• Ability to anticipate and mitigate potential issues
• Accurate and clear communications (oral and written) including phone demeanor and presentation skills
• Training and education delivery (communication and safety program development and delivery skills)
• Strong analysis and assessment skills
• Investigation and documentation skills
• Bachelor’s degree in Business or Risk Management-related field or equivalent experience

Nice To Haves

• OSHA certification preferred, but not required

Responsibilities

• Provide Senior level claims management of severe claims arising from a defined region of the business
• Conduct and oversee workers compensation claims management for the East or West division of the company
• Receive and manage referred serious or time loss cases from analysts and complete Initial Claim intake
• Work with supervisor/employee to address modified duty and document RAP in Sales Force
• Conduct and document employer Level Investigation and determine compensability and safety assessment
• Refer identified safety violations to Safety based on policy or Corrective/Preventative (CAP) Measures
• Prepare letters, forms and authorization of treatment
• Process and coordinate with Benefits LOA for FMLA and ADA for time loss claims
• Run FMLA Eligibility
• Send letters and track for 12 weeks
• Provide ADA Leave (6 months)
• Determine wage statements and conduct initial discovery
• Full litigation and claim resolution authority
• Complete Interactive Process if assignment of permanent work restrictions
• Claim handling of Medical Only claims with Total Incurred in excess of $20,000
• Handle Indemnity Claims and dispositions (Accepted/Delayed/Denied)
• Approve reserve recommendations, settlements up to $100k; consult with Director for settlement concurrence in excess of authority
• Track and conduct analysis of claims data and assess and recommend safety training opportunities
• Review claims processes to determine and recommend changes to process, including technology integration to streamline and increase efficiencies
• Comply with federal, state and local legal requirements by being knowledgeable of existing and new legislation, ensuring adherence to requirements and advising management on needed action
• Execute and maintain OSHA-related regulatory programs and documentation
• Review accident investigations, injuries, and OSHA logs; analyze and determine trends
• Identify opportunities to bring greater awareness and/or training to the safety team and work with team to track effectiveness of safety training
• Work with insurance administrators to ensure effective coordination, along with efficient and full use of applicable resources
• Work with insurance carriers, legal and Risk management team to continuously improve on processes to bring greater efficiencies
• Support Director of Risk management in reviewing and updating the overall claim management and safety training strategy
• Effectively handle information and reports while maintaining the strictest confidentiality
• Manage regular preparation of relevant management reports, including weekly, monthly, quarterly and year-end reports
• Respond to worker’s compensation questions from company leadership, former employees, insurance carrier, claims administration vendors, representatives and government agencies in a timely manner
• Properly document and maintain worker’s compensation claims activities, documents, interactions and related materials in designated applications
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, or participating in professional societies

Benefits

• medical
• dental
• vision
• prescription drugs
• Paid Time Off
• Paid Holidays
• Sick Time
• Life Insurance
• Short Term Disability – Employer paid
• Long Term Disability
• Supplemental Health Insurance (E.G., Accident)
• 401k plan with a match or Non-qualified Deferred Compensation Plan
• Pet Insurance
• PerkSpot Discount Program – discounts on travel, gyms, cell phones, restaurants, auto, apparel & electronics

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees