This position is part of the Risk Mgt/Insurance function within the Finance Department and reports to the Director of Risk Management. The Claims Specialist is responsible for familiarizing themselves with the various loss exposures of the company, reviewing/evaluating claims as they are incurred and taking the appropriate steps to ensure a quick and proper resolution of those claims. Activities would involve assisting the field with claims intake, facilitating the flow of information between the field and the company’s various TPAs, helping identify return to work opportunities, communicating challenges and outcomes to management, etc.

The specialist will utilize the Risk Management Information System to track and help manage claims for the most common lines incurred by the company; Workers Compensation, Auto Liability and General Liability and may also be asked to become involved with Property claims as needed. They will help to manage the TPAs themselves by daily monitoring their activities and taking the appropriate steps to ensure the best claims-handling possible through periodic claim reviews and working with the HR representatives in the field.

This individual will help create and distribute meaningful loss reports to the businesses to help them identify areas for improvement. The Specialist will be asked to supply loss reports for insurance renewals and actuarial analysis as needed as well as work with the Safety management team to support their claims reporting needs.

The specialist will also monitor, advocate for, and assist with the use of loss mitigation tools available through the TPA such as the post-injury nurse hotline, the claims concierge service, and nurse case management as needed. They will also help to develop programs such as RTW and early claims reporting. They will be the primary relationship holder for reach of the TPAs and will help to negotiate those fees and contracts.

Will interact with claims adjusters, internal managers and both inside and outside counsel to help arrive at optimal claim outcomes, balancing the needs of employees, third parties, and the company.

The position will help implement a new Risk Management Information System (RMIS) for the company and may serve as a consultant regarding bet practices in general regarding claims incurred both in the U.S. and internationally.

Duties/Responsibilities

• Generate claims reports to the field, help to boil down and motivate
• Assist management and employees with reporting claims
• Watch progress on claims to assure optimal outcomes
• Assist employees and company management to navigate their claims, get to the correct physician, provide the right documentation, etc.
• May help gather claims data for insurance renewals

Skills/Abilities

• Highly effective communicator
• Assertive but capable of inspiring cooperation and compromise as needed
• Broad understanding of Workers Comp claims across multiple states
• Comfortable working with claims reporting tools
• Strong interest in legal principles and theories of liability
• Efficient and organized, with an eye for detail
• Self-starter; driven to improve processes
• Comfortable managing multiple priorities simultaneously; flexible
• Able to work independently and follow tasks through to completion

Requirements

• Minimum five years’ experience working with WC claims
• Some experience working with other types of liability claims (auto or general liability) preferred
• Comfortable with claims and reporting software
• Proficiency with spreadsheets, interest in creating meaningful graphs, charts preferred
• Supervisory experience preferred
• Experience with a RMIS or claims management software highly preferred