Workers Compensation Claims Management Opportunities

A Workers Compensation Claims Director is primarily responsible for the technical quality of WC Claims handling for key clients across multiple units.  This is accomplished through implementing training and managing the quality work product and conducting audits. 

• Adherence to Best Practices and Throughput:  Responsible for implementing strategies aimed at improving quality.  The CD will partner with Ops to strategize on improving the technical work product and throughput to include:
  • Quarterly audit results, analysis and action plans to improve the technical quality of the open inventory
  • Claim roundtables, based on exposure, to move claims to timely resolution
• Working with the claims teams, the individual will provide continual feedback as to the effectiveness of said strategies, perform compliance oversight and drive closures. 
• Client Stewardship and Interface: Serve as an extension of each unit handling a given client's files.  Communicate technical instruction and feedback concerning client expectations, ensuring the client’s philosophy is understood and carried out in each unit.  The individual is expected to attend audits/claim reviews, develop a personal relationship with each key client stakeholder and identify areas where we can offer additional value to our own or to our client's services.  The CD is also responsible to ensure that the client instructions are followed.
• Audit Prep and Action Plans: Assist the Branch Unit Manager in reviewing and preparing files for customer audits and in the development and execution of sound action plans to improve future performance.
• Workflow Process Improvement and Consistency: Perform oversight of technical claims handling across multiple units in order to develop a global technical view of how a client is managed.  This will enable the individuals to detect trends and opportunities for workflow improvement leading to a more consistent and efficient product.  One key responsibility will be to work with Operations Management staff to limit the number of offices, units and adjusters servicing a given client.  When additions to staff are necessary, the individual may assist in interviewing candidates to ensure the addition to staff will meet the needs of the client. 

EDUCATION:

• BS / BA or Equivalent Work Experience

EXPERIENCE:

• 5 to 8 Years

SKILLS/ABILITIES:

• Organizational
• Communication (written and verbal)
• Decision making
• Technical Claim Skills
• Performance and objective setting skills
• Ability to work within a team structure with accountability for results
• Leadership experience

KNOWLEDGE:

• Workers Compensation claims handling.  Multi-jurisdictional is a plus.
• Claims handling principles including aggressive investigation, reserve analysis, litigation and medical management, subrogation
• Effective settlement negotiation and resolution strategies