Claim Professional I

Aon Corporation•Virtual, TX

2h•Remote

About The Position

The Claims Professional is responsible for implementing aspects of assigned projects and their workers’ compensation program (statutory and USL&H); multiple jurisdictions and time zones. The position will support multiple projects from remote base work location, with required travel as directed by Client. The work week will exceed 40hrs, as a salaried position. While this is an AON position, the employee is seconded to Bechtel. The Claims Professional works under the direction of Bechtel Head of Workers’ Compensation and the AON Claims Director, acting independently to manage routine matters while keeping Bechtel Insured Claims team fully informed at all stages.

Requirements

Requires a Bachelor’s Degree or at least 7 years of experience in the field or in a related area.
Extensive knowledge of / experience with workers’ compensation and occupational rehabilitation procedures, practices and processes.
Extensive knowledge of claim’s resolution techniques and strategies, legal principles related to claim resolution and familiarity with all phases of the litigation process.
Working knowledge of / experience with bodily injury and 1st and 3rd party property damage claims practices and processes.
Working knowledge of / experience with auto and other insured claims practices and procedures.
Relies on experience and judgment to plan and accomplish goals.
Highly skilled in written and verbal communication.
Bilingual language proficiency (i.e., English and Spanish) is a plus.

Responsibilities

Communicates effectively with injured workers, medical professionals, insurers, brokers, internal/external counsel, corporate management, and various related regulatory agencies.
Develops and maintains project-specific workers’ compensation claims manual (assigned projects) including medical panel, related processes and procedures for statutory and USL&H claims. Implements improvements based on lessons learned, legislative changes or Court decisions, and Bechtel operating imperatives.
Assists project management to include ES&H, Labor Relations, Industrial Relations and onsite medical.
Develops and provides onsite training related to workers’ compensation.
Under the guidance of the Bechtel Head of Workers’ Compensation, develops and prepares regular reports outlining project claims performance. Monitors claims activity to identify early negative claim trends or other issues that may negatively impact project performance.
Is responsible for oversight and processing of workers’ compensation claims:
Responsible for ensuring claims are being filed timely, managed per their respective jurisdiction, State specific guidelines are meet by Employer, while working closely with the assigned TPA/Insurer.
Investigates and documents eligibility for workers’ compensation benefits and communicates same to insurer and related interested parties.
Assists with investigation and coordination of issues surrounding subrogation.
Interprets laws and regulations, determines appropriate courses of action, and presents solutions to resolve the claims.
Identifies potential subrogation issues.
Monitors claim resolution activities implemented by insurer(s) and employers.
Maintains Project Risk Management Information System (RMIS) for assigned projects.
Directs and monitors the activities and performance of Bechtel’s insurance provider to ensure compliance with applicable regulations.
Implements, monitors, and ensures compliance of “Special Account” requirements.
Conducts regular claim reviews, claim audits and prepares related reports.
Interfaces with insurer to effectively manage claims, including but not limited to authorizing claim reserve changes, authorizing insurer referral to outside counsel, and assessing and approving settlement strategies.
Coordinates and supports early return to work.
Manages relationships with onsite clinic, panel/network physicians and other medical providers, to ensure effective claims management and return to work.
Works with injured worker and supervision on developing and implementing return to work plan.
Assists in management fitness for duty and ADA accommodation issues as needed.
Assists Bechtel Insured Claims in the defense of litigation or other complex case support. (i.e., responding to interrogatories and other discovery requests).
Assists with gathering information and filing auto and other insured claims. Assists with administration of auto and other insured claims as needed.
Performs other tasks as required by Bechtel Insured Claims.
Willingness to learn and manager multiple jurisdiction and expand along with business needs.