Workers Compensation Claims Manager

Turner Construction • New York, NY

71d • $112,000 - $173,000

About The Position

The position involves overseeing insurance carriers and Third-Party Administrators (TPAs) in managing and handling affiliated clients' Workers' Compensation claims in a designated geographic region. The role requires a comprehensive understanding of workers' compensation policies and the ability to manage incidents effectively. The individual will collaborate closely with Risk Management leadership to ensure an integrated program and serve as a resource for injured employees regarding the workers' compensation process. Responsibilities include reporting claims, facilitating early Return to Work programs, evaluating claims, and maintaining documentation in the Risk Management information system. The position also involves working with various stakeholders to develop mitigation strategies and ensure compliance with best practices.

Requirements

• Bachelor Degree in Insurance, Risk Management, Finance, Business Administration or related program.
• Minimum of 8 years of workers' compensation claims administration experience.
• Experience with workers' compensation claims in a construction environment, desired.
• CRIS, ARM or similar insurance designation, desired.
• Knowledge of jurisdictional laws and regulations for assigned territory.
• OSHA knowledge and experience desired; OSHA 30-hour certification, a plus.
• In-depth knowledge of workers' compensation claims, medical management procedures, medical cost containment programs and applicable laws and regulations.
• Demonstrate process thinking and sound decision-making skills.
• Analytical and adept at processing and breaking down data into actionable information.
• Self-starter with strong project management skills.
• Demonstrate strong interpersonal and teamwork skills.
• Professional written and verbal communication, and effective presentation skills.
• Proficient computer skills, Microsoft Office suite of applications, and insurance-based risk management information systems.

Nice To Haves

• Experience with workers' compensation claims in a construction environment.
• CRIS, ARM or similar insurance designation.
• OSHA 30-hour certification.

Responsibilities

• Oversee assigned workers' compensation case portfolio of minor to complex claims in assigned geographic region.
• Leverage knowledge of workers' compensation policy and manage incidents, and dispatch nurse case managers as necessary.
• Collaborate closely with Risk Management leadership on workers' compensation claims, process, and procedures to ensure integrated program.
• Serve as resource for injured employees and inform of workers' compensation process and procedures.
• Report workers' compensation claims to carriers and Third-Party Administrators (TPAs), including notification of questionable claims.
• Facilitate proactive identification of claims with opportunities for early Return to Work and light duty Return to Work program, as needed.
• Evaluate and respond to Reserve and Settlement Consultations within given authority, escalate consultations above scope authority to appropriate leadership.
• Maintain diary for open claims and document specific claim related activities in Risk Management information system.
• Work with carriers, TPAs, and Defense Counsel to develop mitigation strategies for Owner Controlled Insurance Program (OCIP) that result in cost savings to the claim.
• Collaborate with General Liability team to develop mitigation strategies and facilitate most economic global resolution of Contractor Controlled Insurance Program (CCIP) claims.
• Attend hearings and mediations on as needed basis.
• Ensure avenues for potential claim recovery are identified and pursued and manage lien recovery on case-by-case basis.
• Participate in claims review process and monitor claims handling process by carriers and TPAs.
• Oversee and hold vendors and defense firms accountable for adherence to standard protocols, agreed to service instructions, and litigation management guidelines.
• Partner with Safety team and onsite medics on initiatives that support worker wellness and post-injury care.
• Participate in CCIP kickoff meetings and jobsite walkthroughs.
• Maintain and foster relationships with carriers and TPAs claims teams.
• Assist with claim data analysis and claim performance reports.
• Collaborate with HR and Payroll departments for completion of required Workers' Compensation Jurisdictional Forms.
• Support audits related to workers' compensation claims.
• Remain current on Workers' Compensation laws and regulations, industry trends, and case law within assigned jurisdictions.

Benefits

• 401k
• health insurance
• dental insurance
• vision insurance
• life insurance
• disability insurance
• paid holidays
• paid volunteer time
• tuition reimbursement
• professional development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Construction of Buildings
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees