Leave of Absence Specialist

Fashion Nova•Santa Fe Springs, CA

7d•Onsite

About The Position

Fashion Nova is an inclusive fashion-forward and trend-driven apparel and lifestyle brand that celebrates all dimensions of confidence. We use our platform to spread positivity with brands for women, men, curve, luxe, sport, swim, beauty, and kids. We are obsessed with creating the best experience available for our customers and employees. Fashion Nova was built on the backbone of individuality and inclusiveness. Our brands are worn and celebrated worldwide by customers, celebrities, and influencers because of our uniquely creative and talented employees. The Manager, Workers' Compensation is responsible for supervising and monitoring Fashion Nova’s Workers’ Compensation program at all company owned and operated locations. The Manager, Workers' Compensation will be responsible for developing and collaborating successful partnerships with our associates, Third-Party Administrators (TPAs), internal stakeholders and service providers. POSITION IS ONSITE IN SANTA FE SPRINGS | HYBRID|REMOTE WORK IS NOT POSSIBLE

Requirements

Five plus years of experience processing lost time workers’ compensation claims, preferably for an employer with a high-deductible program
Bachelor’s degree in Business Administration or Finance
IIA, AIC, AEI, and|or CPCU Designations | Self-Insured Certification highly encouraged
Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business
Excellent oral and written communication, including exceptional presentation skills
Advanced knowledge of Google Suite
Experience with fraud investigations
Knowledge of medical terminology
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Responsibilities

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims
Manages reserve adequacy throughout the life of the claim, providing Finance with monthly updates
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost-effective claims resolution
Coordinates vendor referrals for additional investigation and/or litigation management
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
Manages claim recoveries, including but not limited to, subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
Communicates claim activity and processing with the claimant and Leadership; maintains professional client relationships
Ensures claim files are properly documented and claims coding is correct
Refers cases as appropriate to supervisor and management
Partners with multiple departments to coordinate and supervise the Return-to-Work program for team members to ensure work restrictions and transitional work guidelines are being adhered to
Availability and|or work evenings and weekends as dictated by business needs