Worker Comp Claims Specialist

Job Description

Job Description – Workers Comp Claims Specialist

PURPOSE

Support the development, implementation, and continuous improvement of administrative systems that drive efficient risk management operations at Masis Staffing Solutions, LLC. Oversee workers’ compensation claims, budgeting, and client loss ratios to optimize cost control, ensure compliance, and minimize financial risks. This contributes to the efficient Masis operations by performing their duties accurately and promptly.

ROLE AND RESPONSIBILITIES

• Work with the Risk Management Team to complete Workers’ Compensation claims, client loss control surveys, and training for clients and staff.

• Oversee, monitor, and investigate all Workers’ Compensation claims reported from multiple locations/states.

• Manage & coordinate the claims process to ensure cost control, appropriate loss payment, staffing, performance measurement & continuous improvement.

• Investigate, evaluate, and negotiate lower complexity claims in compliance with established company technical and customer service Best Practices.

• Review claim files regularly for quality.

• Coach and counsel employees on compliance in a responsive and timely manner.

• Implement effective ways (internal/external) to monitor and evaluate the client’s risk management concerns, issues, satisfaction, and anticipate customer needs.

• Lead meetings in collaboration with the Regional Risk Manager, VP of Risk Management, and other team members to communicate goals and direct reports and reinforce/monitor the Risk Management Strategy.

• Maintain knowledge of current industry developments and best practices.

• Participate in committees and projects that will support the organization’s goals and objectives.

• Communicate regularly with ownership, branch staff, territory managers, injured employees, doctors, attorneys, claim adjusters, account managers, brokers, and other insurance personnel.

• Work with insurance carriers on mitigating losses using investigators, nurse managers, and other tools available.

Human Resources Department

• Attend quarterly claim reviews to ensure all claims are moving towards a resolution.

• Report all claims to insurance carriers.

• Provide direction through training, coaching, and development of all levels of staff.

• Meet or exceed safety standard goals established by the Risk Department.

• Performs other duties as requested.

QUALIFICATIONS AND EDUCATIONAL REQUIREMENTS

• Bachelor’s Degree or 5 years in Risk Management and claims preferred.

• Thorough knowledge of all fields of insurance laws of the PRIMARY STATE.

• Though knowledge of the Workers’ Compensation statutes and other Federal and State laws related to personal injury, property damage, vehicle accidents, and other risks.

• 5 – 10 years of experience with management practices and administrative processes.

• Ability to analyze, classify, and rate risks, exposures, and loss expectancies preferred.

• Ability to plan, assign, and direct the work of subordinate employees engaged in various aspects of claims handling.

• Ability to establish and maintain effective collaborative working relationships with management and coworkers.

REQUIRED SKILLS

• High level of leadership skills.

• Excellent communications and interpersonal skills.

• Ability to manage and direct reports.

• Experience analyzing numerical data and leading quality programs.

• Attention to detail and problem-solving skills.

• Ability to report to multiple levels of management.

• Organized and able to manage multiple projects with routine results.

• Ability to easily build rapport and communicate with others through different levels of communication.

• Altruistic and willing to put others before yourself.

• Desire to help foster and preserve a company culture where all are encouraged, included, and find success.

• Able to think quickly on your feet.

• Excellent work ethic and the desire to advance your career.

• High level of concentration.

• Proactive and independent with the ability to take initiative.

• Excellent time management skills with a proven ability to meet deadlines.

• Proficient with Microsoft Office Suite and other related software.

• Proven track record driving & executing best-in-class service.

ADDITIONAL NOTES

Routine office environment. Infrequent after-hours availability may be needed to address urgent incidents or claims matters.