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Chicago, IL
(Click company name to view employer profile and all available positions.)
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| Career Field |
Claims
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| Insurance Discipline |
All
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| Relocation Assistance |
Not Available
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| Job Duration |
Full Time |
| Salary Offered |
Open
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GENERAL SUMMARY
The individual holding this position will be responsible for the quality of workers’ compensation claim handling for a technical team of Adjusters and clerical support.
ESSENTIAL RESPONSIBILITIES & DUTIES
• Development of expertise of the staff through mentoring and technical guidance
• Ensure workers’ compensation claim file quality
o Participate in Corporate Audits
o Conducts Monthly Self Audits of each Adjuster, including Medical Only Adjuster
o Develops Corrective Action Plans when necessary to address audit deficiencies
• Maintains a workers’ compensation diary of files in unit based on reserve and autonomy levels
• Provide technical direction to staff through initial file assignments and on follow up diary reviews
• Maintains equitable work loads within the workers’ compensation unit and ensures assignments are based on Adjusters demonstrated ability
• Works with Managed Care Analyst to ensure compliance with managed care program
• Develop a knowledge of the PEO business
• Work with Workers’ Compensation Corporate Claim Analysts to establish strategies and resolve claims
• Works with the Subrogation Analyst to maxinize all recoveries on eligible claims
• Monitors expense control through approval of vendors and activity based assignments
• Exhibits superior customer service capabilities through:
o Effective interaction with Partner Agents
o Effective interaction with PEOs and their clients
o Effective interaction with other insureds
o Assuring timeliness of claim responses from all parties to claims
o Taking an active role in claim reviews
o Prompt issue resolution
o Adherence to regulatory requirements
• Exceeds quality expectations as outlined in SUA Best Practices
• Manages other assignments given by the Worker’s Compensation Director or Claim Manager
DESIRED QUALIFICATIONS
• Education
o Bachelors Degree
o CPCU or other professional claims designation is a plus
• Experience
o 5-10 years experience in a Workers’ Compensation claims insurance environment
o 2-4 years experience in a Workers’ Compensation claims supervisory capacity
• Skills
o Ability to lead, train and develop a superior claim team to obtain optimal outcomes.
o Drive behaviors to provide superior claim service to achieve satisfaction of internal and external customers
o In-depth knowledge of Workers’ Compensation claim handling best practics and multi-jurisdictional law
o Ability to analyze complex workers’ compensation claims and formulate a strategy to bring claim to conclusion
o Produce efficient and effective claim outcomes at a reasonable cost, avoid litigation whenever appropriate, and aggressively manage this when necessary. This includes timely management of high exposure claims, controlling loss costs and vendor management.
o Assist in the recruiting and selection process
o Ability to develop program-specific expertise and competency skills
o Proficient knowledge of Microsoft Office Products (i.e. Excel, Word, Outlook)
o Drives self and others towards results and success. Holds people accountable.
o Establishes clear relevant performance objectives and measures with Manager. Reqularly monitors performance. Acts timely to address performance issues identified through quality reviews. Recognizes achievments.
o Promotes teamwork, cooperation and commitment throughout the organization.
o Proficient in the use of the Claims+ claim system
• Physical
o Occasional bending, reaching, and light physical effort (under 10 pounds) required.
o Occasional travel required (20%)
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