Description
Responsibilities- Assists the Risk Manager in the handling of the corporation's property and casualty risk management programs with an emphasis on workers' compensation claims.
- Provides technical claim support and monitors third-party and/or carrier activity.
- Prepares and maintains underwriting data, first level contract review, communication of programs to business units, and departmental accounting.
- Supervises internal workers' compensation, general liability and auto liability claims reporting, investigation and disposition.
- Acts as workers' compensation claims resource to corporate and business unit management and supervisory personnel.
- Monitors casualty, emphasis on workers compensation claims, including close supervision of large and/or severe cases
- Consults with attorneys, adjusters and carriers regarding claims or claims services.
- Assesses the reserve practices of claims administrator.
- Settles claims within the authority level and prepares reports to seek higher settlement authority.
- Implements and/or supports corporate-wide return to work/transitional duty programs.
- Conducts periodic claims review audits to evaluate and direct TPA performance.
- Analyzes claim trends to develop recommendations for improved safety and claims management efforts.
- Provides data input and maintains claims administrator systems.
- Maintains diary system and files for all claims - open to close.
- Attends business unit claims reviews, as necessary.
- Assists in the collection and management of current and historical exposure information on a timely basis for all risk financing/insurance programs.
- Arranges for timely payment of all costs associated with the cost of risk; keeps accurate records of risk management expenses.
- Provides ongoing risk management support and assistance as needed.
- Prepares reports to corporate and business unit management regarding workers compensation claims, including large and/or severe cases.
- Assists in the development and updating of a Claims Manual for management and business units
- Gathers current and historical claims activities and large losses data for management reports.
- Serves as a resource to business units on claims handling issues.
- Provides new locations with claims packets for claims reporting.
- Develops and maintains a workers' compensation claims procedures manual for business unit supervisors and other internal claims processors.
- Consults with Claims Manager and TPA and/or carrier to develop customized claims handling procedures.
- Assists in the review of outside claims administrators (TPAs) and/or carrier for effectiveness and cost containment.
- Assists in developing quality control procedures, as necessary, implement and monitor compliance.
- Trains business unit supervisors in claims best practices.
Must have a college degree with ARM or ACM designation, CPCU course work. Seven to ten years of workers' compensation claims experience, with multiple states' programs required. Must possess thorough knowledge of casualty coverage, terms, conditions and exclusions as well as insurance case law and basic tort law.
Excellent verbal and written communication skills required. Must have the ability to read, analyze and interpret insurance policies, general business periodicals, professional journals, legal documents, technical procedures or governmental regulations, as well as the ability to solve practical problems in situations where only limited standardization exists. Excellent administrative and organizational skills needed. Must have good computer skills in the Windows environment, with working knowledge of Word, Excel, Access, Lotus Notes software, and on-line data base claims systems.
Synectics is an Equal Opportunity Employer.