Regional Manager - Eastern Region Workers Compensation

Acrisure • Bradenton, FL

4d • Onsite

About The Position

Summary/Objective : Oversees direct reports (6-7 Full Time direct reports) in determining coverage, compensability, benefits due; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; to identify subrogation of claims, clear and concise action plans, reserving and settlements.

Requirements

• In-depth knowledge 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 presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Excellent negotiation skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies
• Thoroughness.
• Technical Capacity.
• Problem Solving.

Nice To Haves

• Bachelor’s Degree (preferred), or equivalent experience (8-10 yrs) of adjusting experience.
• Knowledge in multi-state jurisdiction, is a plus. Also willing to learn additional jurisdictions.
• Ability to multitask, organize, prioritize, handle a fast-paced environment, and manage workload with a positive attitude and minimal supervision.
• Strong written and verbal communication skills, as well as attention to detail.
• Professional certifications as applicable to line of business is a plus.

Responsibilities

• Review, assign and supervise all claim activity for designated claims to ensure compliance with company best practices, client specific handling instructions and in accordance with applicable laws.
• Responsible for oversight in assessing compensability, coverage, AWW/CR and timely payments.
• Reviews and approves settlement of claims within designated authority.
• Responsible for overseeing reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
• Monitors necessary state filings within statutory limits.
• Oversees the litigation process; ensures timely and cost-effective claims resolution.
• Reviews vendor referrals utilized in investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Monitors and approves claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate for further review.
• Leads team manager meetings and assigns accountability for follow-up items.
• Mentors and provide ongoing training and assist in the development of claim staff.
• Review and maintain supervisory diary on claim system.
• Ovrseeing of all claim activity for specified accounts.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
• Key part of the team with Team Manager/Lead to interview adjusters and provide feedback.
• Provides assistance/support to Team Manager/Lead with monthly review of adjusted workloads; notes trends and suggests adjustments when necessary.
• Participates in claim reviews both telephonic and in person as needed.
• Participates in onsite meetings with insureds.
• Collaborates with adjuster, team managers, insureds, and brokers on a regular basis.
• Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
• Supports the organization and management.
• Some travel may be required.

Benefits

• Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
• Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
• Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
• Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.

What This Job Offers

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