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Work Comp Regional Claims Manager (TEXAS)
San Antonio, TXPOSITION SUMMARY
This is a Regional Claims Manager full time direct hire position to support a Workers Compensation department, by leading a team of Work Comp Claims Supervisors in Texas.
PRIMARY RESPONSIBILITIES
Essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
ACCOUNTABILITIES
Supervisory Responsibilities
Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions.
Manager in the Field Responsibilities:
POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
This is a Regional Claims Manager full time direct hire position to support a Workers Compensation department, by leading a team of Work Comp Claims Supervisors in Texas.
PRIMARY RESPONSIBILITIES
Essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
- Work with executives to achieve company initiatives and performance goals
- Work with clients with issues regarding policies, programs and/or claims
- Provide guidance, coaching and direct supervision to staff daily
- Coordinate and perform claims training
- Manage the direct hiring process including coordination with Human Resources, selecting qualified candidates
- Review performance of staff and manage performance issues
- Develop and administer departmental policies
- Resolve personnel/ workflow problems
- Lead staff unit meetings
- Attend client meetings, in-house meetings, and workers’ compensation meetings
- Present annual stewardship reports to clients
- Authorize release of payment and settlement
- Make daily claims decisions regarding plan of action, handling of payment, etc
- Work collaboratively with COMPANY’s and clients’ senior management
- Provide information to clients, investigators, and injured workers
- Work collaboratively with attorneys to draft settlements and assist with litigation strategies
- Handle all audit responses to ensure consistency throughout the department. Incorporate audit results into other quality measures, ensuring necessary improvements are accomplished
- Ensure consistent and accurate claims coding is occurring throughout the organization
- Work collaboratively with the Sales Team on presentations for potential new clients
ACCOUNTABILITIES
Supervisory Responsibilities
Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions.
- Provide direct supervision to Claims Supervisors. Also provide partial direct supervision to ancillary staff, such as Hearing Representatives, investigators, etc.
- Review and approve direct report’s monthly expense reports
- Claims budget planning and salary administration
- Responsible for education expenses
Manager in the Field Responsibilities:
- Branch office facilities management
- Coordinate building functions: security, maintenance, parking, and safety
POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
- High School Diploma or equivalent (GED) required for all positions
- AA/AS or BA/BS strongly preferred
- The Texas 03 Workers’ Compensation license is required
- The 08 All Lines License is preferred
- Previous workers’ compensation claims experience with a minimum of (3) years of supervisory experience including hiring, training, developing, retaining, and directing staff
- 2+ years management experience over a Workers’ Compensation office preferred
- Ability to attend in person meetings and file reviews
- Willing to attend client meetings and conferences at off-site locations
- Completion of IEA or equivalent courses
- Solid knowledge of workers’ compensation laws, policies, and procedures
- Proficiency in determining case value and negotiating settlements
- Understanding of medical and legal terminology
- Prior Third-Party Administrator (TPA) experience preferred
- Superior communication skills (written and verbal), ability to follow directions, work under difficult time restraints, prioritize work, and exercise teamwork attitude
- Maintain confidentiality of information
- Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives
- Leverages technology for self and staff to improve efficiency
- Handles stressful situations and deadline pressures well
- Entrepreneurial
- Thinks strategically and creatively about business (pricing, products, and outcomes)
- Execute tasks versus being a manager of people that executes tasks
- Highly developed organizational skills to meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives
- Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully
- Command of company and department policies, practices and procedures including supervision, training, and performance evaluation
- Able to interpret information from multiple sources and draw logical conclusions; consults others based on analysis of data; able to think strategically and use data findings to consult others for improved business results
- Skilled at presenting in small and large group settings
- Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals
- Must be flexible, adaptable, and positive. Exhibit passion and energy for ensuring that all employees are respected and treated in a manner consistent with COMPANY Values
- Able to plan, prioritize and organize claims workload for a unit
- Self-directed: able to independently evaluate and determine priorities and manage projects and personnel.
- Mathematical calculating skills
- Exercise independent judgment and analytic ability in solving complex and sensitive problems
- Ability to type quickly, accurately and for prolonged periods
- Proficient in Microsoft Office Suite
- Ability to learn additional computer programs
- Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues and make appropriate recommendations and solutions for resolution
- Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
- Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
- Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
- Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
- COMPANY’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
- Valid Driver’s license and availability for travel including overnight throughout Texas