Claims Manager

Sunrise Group

1d•Onsite

About The Position

Sunrise is one of the largest, private not-for-profit organizations in the country dedicated to serving people with intellectual and developmental disabilities. At Sunrise we pride ourselves in taking an individualized approach in addressing the unique needs of each person seeking or receiving services. As an employer, we seek to provide an environment of growth and development for our employees that is consistent with recognizing the rights, needs, and wants of all people.

Requirements

Must successfully complete the required pre-employment Background and Drug Screenings
Must possess a valid Driver's License with all necessary endorsements and have a minimum of 3 years of driving experience
Must possess an Bachelor’s Degree
Must possess at least seven years of experience in a Claims or Risk Management capacity
Must have at least 2 years' experience in a supervisory role
Must possess strong analytical and computer skills

Responsibilities

Manages all claims throughout the Organization.
Handles with the following functions regarding claims: reporting litigated claims to carriers, opening files for each claimant, assisting with requests of production of documents and discovery, scheduling depositions as needed, processing payments and invoices from attorneys and or insurance carrier
Communicates with corresponding claim adjusters to make sure they have all pertinent information. Contacts adjusters and respond to any questions.
Coordinates all meetings and communications between counsel, insurance adjusters, and employees.
Maintains communication with operations to obtain claim forms or any items relevant to the claim as well as accommodation matters. Answers, updates, and provides assistance to the relevant parties in field regarding claims.
For WC claims, keeps track and makes sure the employee is attending the follow-ups to address their current work status and progress. Provides updates to the field as well as to the adjuster on file; coordinates transitional duty accommodations between operations, employee, and carrier. Monitors length of time of accommodations and follows up on the timing of Maximum Medical Improvement for injured workers ensures compliance with Company procedures and State and Federal regulations.
Assists Quality Enhancement department with incident reports and attends all pertinent meetings.
Responsible for processes, including, but not limited to claim budgeting, claim bill processing, and tracking financial spends.
Attend required meetings and trainings.
Supervises and manages claims staff.
Acts as backup for VP of Risk Management in their absence.
Performs all other duties as assigned.