Claims Manager - Worker's Compensation

CLAIMS MANAGER　- WORKERS COMPENSATION 　

MUST BE WILLING TO RELOCATE TO CHESAPEAKE, VA　

THE OPPORTUNITY　　

The Claims Manager is to support the Company’s claims management function with an emphasis on workers’ compensation matters. The Manager will also coordinate other claims management projects as defined by the Director. The Claims Manager will assist in forming and implementing strategies for prompt and economical resolution of all claim types. The Claims Manager will work closely with claims examiners to determine case reserves, negotiate claim resolution, and work with outside counsel to achieve the best possible outcomes.

Responsibilites 
 　

- Manage complex workers compensation claims to reduce costs and improve outcomes (80%)
- Direct Third Party Administrator (TPA) claims examiners and outside counsel on litigated
- Communicate policy related to accident reporting and managed care programs　
- Monitor and evaluate the performance of outside counsel
- Stay current with key changes in the legal and regulatory environment　
- Manage workers compensation litigation budgets, evaluate adequacy of case reserves and advise on adjustments where necessary
- Review and manage requests for investigations, discovery, and mediation/trial preparation 
-Establish and manage a regular cadence of claim review meetings with internal and external stakeholders to assist in managing claim developments and capturing high severity claims in early stages　
- Authorize reserve and settlements on higher severity workers compensation claims　
- Initiate audits and file reviews at TPA evaluating TPA performance nationwide　
- Initiate and manage the Company’s return to work programs including collaboration with field operations and development of metrics that measure the success of the program. 　
- Partner with business units and TPA to utilize all tools available for ‘Return To Work’ programs, nurse case management, etc. 　
- Coordinate the assemble and execution of the discovery required by internal and external stakeholders　
- Communicate with internal or external business professionals, attorneys and/or other third parties　
- Possess or acquire knowledge about Company departments and functions including required claims functions　
- Communicate with the Director, Claims Management to develop case strategy in effort to ensure the best possible results
- Approves and/or pays bills as appropriate 
-Assist with general liability, auto liability, subrogation, property claims and other special claim management projects as necessary (5%)　
- Develop and manage fleet management safety and claims programs for company car drivers (5%)　
- Special projects assigned by Director, Claims Management and VP, Risk Management (10%)

Minimum Requirements/Qualifications　　

- Bachelor’s Degree; equivalent work experience may substitute　
- 3 years of multi state claims handling experience with insurance carrier, third party administrator or insurance broker or experience in analyst role in similar operating environment. 
-Analytical skills required in order to assemble and interpret claims, metrics and loss data, and produce regular reports showing status of cases and trends.　
- Strong attention to detail, including regular follow up on action items.　
- Team player with the ability to work in fast paced environment, handling multiple tasks and meeting deadlines.　
- Proficient in software applications, including Excel and Word, as well as other databases, systems and software programs that are commonly utilized in the field. 　
- Must interpret and analyze investigative, medical, legal and other reports. 
-Excellent oral and written communications, including presentation skills.　
- Excellent interpersonal and time management skills as well as a high degree of sound judgment, discretion, and initiative. 　　

Desired Qualifications

-Professional Insurance or Claims Designation