Workers Compensation Claims Manager

Workers Compensation Claims Manager at Confidential Workers Compensation Claims Manager at Confidential in Humble, Texas Posted in 1 day ago.

Type:

full-time

Job Description:

Job Overview:

The Workers Compensation Claims Manager is responsible for the oversight and positive performance of the Company's Third Party Administrator (TPA) as they adjust, manage and administer our workers' compensation claims portfolio insured through traditional Workers Compensation insurance lines, monopolistic states' coverages, Qualified Self-Insurer's programs and through our Captive. The position requires their management to be derived through the use of data, analytics and reporting to produce quantifiable and measurable outcomes.

Job Responsibilities:

Oversight and management through the use of data and analytics of TPA adjuster activities to guarantee compliance with the company's Service Instructions Regular data gathering and intelligence reporting on relevant claims KPI's including but not limited to financials and claims metrics. Direction of TPA adjustment process through litigation and settlement as necessary Review of actuarial data for forecasting budgetary needs and monitoring trends and changes that might affect collateral and program retentions. Creation of improved workflows and processes to enable Risk Management and field representatives to effectively report incidents and ensure delivery to TPA's. Analysis of monthly and quarterly reporting derived from captive activities. Prepare and direct claims file reviews and claims file audits. Conduct and as needed, create cost reduction/mitigation initiatives that are quantifiable and measurable. Work with leadership and department to create and/or improve Return to Work, experience mod investigations, insurance carrier inspections, etc. and act as a subject matter expert to advise and counsel as needed in the loss prevention and mitigation experience.

Minimum Qualifications:

Bachelor's degree or equivalent experience 5+ years of claims handling experience, primarily in liability lines Proven experience managing litigation, workers' compensation, employer's liability claims, and mediations Experience managing a Third-Party Administrator (TPA) or serving as a senior-level adjuster within a TPA Strong analytical skills with experience using data, metrics, and benchmarking to identify trends, reduce costs, and improve outcomes Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word), with strong data analysis and reporting capabilities Demonstrated ability to influence and improve processes, including documenting and streamlining workflows Strong understanding of financial and actuarial concepts related to forecasting and budgeting, with the ability to partner effectively with Finance Proven ability to build collaborative relationships with internal stakeholders, brokers, and external partners Excellent communication, interpersonal, and time management skills Ability to work cross-functionally and drive initiatives across multiple teams

Preferred Qualifications:

All Lines Adjuster License Property & Casualty (P&C) License Experience with alternative risk or finance programs Experience partnering with Safety teams to improve reporting and reduce claims costs

Key Capabilities:

Data-driven decision making and continuous improvement mindset Strategic thinking with a focus on enhancing claims experience Strong stakeholder management and influencing skills Industry designations a plus Degree in Finance, Business, Economics, or related degree preferred.