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Workers Compensation Claims Unit Manager

Company Name:
ER Family of Companies
Our client, a national TPA firm, has an immediate opportunity for aWork CompClaims Unit Manager in their Orlando area location. The Workers Compensation Unit Manager's primary purpose is to ensure that their assigned team delivers a level of claims and customer service that meets and exceeds the client?s expectations on a daily basis. The Unit Manager is a fully dedicated manager, with a typical span of control of 5-8 direct reports, consisting of technical claims staff, and clerical in some cases.




Duties include:

Oversight of Claims Handling Requirements: The Unit Manager (UM) will be held accountable for ensuring that the following claims activities are completed by their examiners in a timely manner which meets client best practices:
Three-point contact
Investigations
Denials
Reserving
Timely delivery of benefits

Regular file reviews: ensuring that all staff are compliant and responsible for reviewing and approving all denials and reserves, ensuring that the examiners are complying with service requirements


Excess Reporting Compliance: ensuring that files are reported on a timely basis to the excess carrier (if applicable) as well as reporting on any required forms with all supporting documentation required.


Closing Ratio/Inventory Reduction: ensuring that their team achieves a closing ratio as required by Best Practices and/or Client Service Instructions in order to maintain or reduce file inventory.


Penalties and E&O?s: ensuring that the Examiners incur no penalties or Errors & Omissions (E&O) on the files that they handle.


Significant Claims Activities: ensuring that those claims with significant claims activity are properly managed from inception to resolution. These claims include but are not limited to high dollar and complex claims. This process will also include delivering exceptional customer service to clients in partnership with our client services team.


Regular File Reviews: conducting regular file reviews for clients as required by the client instructions.


External Audits Preparation & Response: preparing for and responding to external audits in coordination with our client services team. This would include implementing changes to improve performance if necessary.


Client Relations: work with the Client Relations team on customer service issues, attend client meetings & support staff when dealing with clients.


Continuous Improvement:responsible for promoting continuous improvement by providing input.


Training Clients:responsible for assisting in training clients within their area of expertise and as requested by the clients.

REQUIREMENTS
2-5 years Supervisory experience in a Work Comp Claims environment required
Knowledge of FL and GA Work Comp a MUST
Knowledge of TN, NC and SC Work Comp a PLUS
BA / BS degree required, or equivilent work experience

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