Workers Compensation Claims Manager

Turner Construction • Saddle Brook, NJ

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, ensuring compliance with program regulations. The role requires collaboration with various teams to facilitate effective claims management and support injured employees throughout the claims process.

Requirements

• Bachelor Degree in Insurance, Risk Management, Finance, Business Administration or related program.
• Minimum of 8 years of workers' compensation claims administration experience or equivalent combination of education, training, and/or experience.
• Experience with workers' compensation claims in a construction environment is desired.
• CRIS, ARM or similar insurance designation is desired.
• Knowledge of jurisdictional laws and regulations for assigned territory.
• OSHA knowledge and experience desired; OSHA 30-hour certification is a plus.
• In-depth knowledge of workers' compensation claims, medical management procedures, 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.

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, dispatching nurse case managers as necessary.
• Collaborate closely with Risk Management leadership on workers' compensation claims, processes, and procedures to ensure an integrated program.
• Serve as a resource for injured employees and inform them of workers' compensation processes and procedures.
• Report workers' compensation claims to carriers and TPAs, including notification of questionable claims.
• Facilitate proactive identification of claims with opportunities for early Return to Work and light duty Return to Work programs.
• Evaluate and respond to Reserve and Settlement Consultations within given authority, escalating consultations above scope authority to appropriate leadership.
• Maintain diary for open claims and document specific claim-related activities in the 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.
• Collaborate with General Liability team to develop mitigation strategies for Contractor Controlled Insurance Program (CCIP) claims.
• Attend hearings and mediations as needed.
• Ensure avenues for potential claim recovery are identified and pursued, managing lien recovery on a 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 and service instructions.
• 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, attending Claims, Safety, and Operations meetings.
• 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: Senior
• Industry: Construction of Buildings
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees