Workers Compensation Claims Manager
Company: Job Juncture
Posted on: October 13, 2019
Workers Compensation Claims Manager
Evansville, IN USA
Full Time Position + Executive Benefits + Paid Relocation--
Provide oversight and technical advisement for all workers
compensation claims handled and investigated by the WC Claims Team.
Responsible for the direct oversight of coverage and/or
compensability issues to ensure timely recognition and referral in
full compliance with Reporting Guidelines. Ensures compliance with
all claim handling procedures, guidelines and manuals and other
special unit procedures, as developed. Provides timely claim
handling and service, timely compliance with case reserve
practices, Fair Claim Practices Acts, and other compliance
- Review and assign all new loss notices to ensure the timely
assignment of new claims to the appropriate claims staff.
- Manage and direct activities of claim representatives to ensure
full compliance with Claim Handling Guidelines and jurisdictional
- Manage open claim files, including completion of supervisory
diary to ensure adequacy of investigation, case reserving,
evaluation, and reporting.
- Manage expenses in accordance with claims handling procedures.
Ensure Home Office Claim Staff is timely informed of all new and
continuing developments on claims being reportable under published
- Monitor and maintain required licensing and
certification/designation as stipulated by respective state
- Meets with Toyota Safety daily to discuss new WC claims, as
well as updates on existing complex cases.
- Participation in regularly scheduled Claim & Litigation Review
Meetings with TMMI, Toyota Headquarters-TMNA, and Aon LA
- Particpation in WC Trend Review Meetings and regularly
scheduled Stewardship Meetings with TMMI, TMNA, and Aon
- Responsible for overssing go and see activity on dipusted WC
cases, which includes reviewing the job process on the Production
- Provide technical and managerial oversight to the assigned
staff by encouraging the timely, professional and appropriate
handling of all reported claims in accordance with applicable
contract provisions, legal regulations and guidelines, and company
claim handling policies and procedures.
- Ensure compliance of Laserfiche file documentation and claim
system documentation as required by company claim manuals and
- Conduct and register formal quality assurance audits for all
assigned staff in the appropriate audit database to track
compliance with Claims Handling and Regulatory
- Complete documented reviews of all open workers compensation
indemnity claims every 10, and subsequent 45-60 days to ensure
timely and appropriate disposition of all reported claims.
- Ensure all medical only claims are reviewed per Company and
Toyota Special Claim Handling Requirements, and subsequently every
30 days thereafter.
- Participate in the preparation and approval of agreed
litigation plans. Direct and monitor litigated matters to determine
future course of handling and appropriate methods of
- Participate in Home Office audits and/ monthly claim reviews to
ensure compliance to Company Claim Handling Guidelines.
- Direct, guide and develop staff, including providing ongoing
performance feedback and coaching to maximize individual
contributions to achieve desired business results within the
department and company.
- Communicate to assigned claims staff information regarding
policy, plans, trends, results and objectives of the company and
industry to ensure a proactive approach towards full participation
and compliance with internal and industry standards.
- Develop, implement and monitor claim staff training to ensure
compliance with continuing education requirements as well as
established business and career development goals.
- Services the claim needs of our customers including insureds,
claimants, brokers, etc., in accordance with company policy and
procedures, and attends client visitations with underwriters and
other parties to conduct presentations and reviews.
- Maintains ongoing communication with all customers throughout
the claims process in an effort to provide---------------- timely
and appropriate claim status as appropriate and/or required by
- Organize and/or participate in on-site and teleconference claim
reviews, client visits, and service presentations as
- Proficient in utilizing Risk Console and assisting the
customers in use of tool, as well as understanding of the reports
in the RMIS tool.---- Includes participation in monthly meetings
with the customer to discuss WC trends and proposed
counter-measures to reduce WC losses.
Responsible for providing leadership and maintaining an
enthusiastic and appropriately trained claims staff ensuring they
have appropriate knowledge and skill set while adhering to
regulatory requirements and Company Claims Practices, Policies and
Directly supervises 4 non-supervisory employees and 1 claim
supervisor. Carries out management responsibilities in accordance
with the organizations policies and applicable laws.
Responsibilities include interviewing, hiring, and training
employees; planning, assigning, and directing work; appraising
performance; rewarding and disciplining employees; addressing
complaints and resolving problems.
Delegates work assignments; Matches the responsibilities to the
staffs knowledge and expertise; Gives authority to work
independently; Sets expectations and monitors delegated activities;
Provides appropriate structure for career development and prove
recognition for results
Education and Experience Required: --
- Bachelors degree (B. A.) from four-year college or
- 7+ years related claims experience including 5+ years at a
management / supervisory level
- Advanced claim technical training
- Proven leadership ability at the field management
- Excellent verbal and written communication skills
- Effective interpersonal skills and superior problem solving and
decision making skills
Keywords: Job Juncture, Evansville , Workers Compensation Claims Manager, Executive , Evansville, Indiana
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