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Claims Manager
Automation Personnel is seeking an experienced and motivated Claims Manager based out of our company headquarters in Birmingham, Alabama. The Claims Manager provides expert claim handling services in the areas of coverage, compensability, investigation, evaluation, negotiation, litigation management, and resolution of light to serious and complex workers' compensation insurance claims. The Claims Manager will also be an expert technical resource to other Risk and Senior management professionals, business partners, and stakeholders. The position reports to the Director of Risk Management.
Pay Rate$60,000-$70,000 DOE
Schedule & HoursMonday-Friday, 8 a.m.-5 p.m.
Claims Manager Duties & Responsibilities Report all injury claims to the TPA as needed. Demonstrate proficient understanding of reserve philosophy, and the ability to review and challenge the accuracy of TPA reserve requests. Promptly investigate all injury claims. Work with the Risk Director to evaluate TPA claim reserves and recommend adjustments over the life of the claim to reflect changes in exposure. Assist TPA in managing service vendors to achieve an appropriate balance between allocated expense and loss outcome. Evaluate, analyze, and determine compensability, causation, offsets, and exposures of light to serious and complex workers’ compensation insurance claims. Document all claim activities in the claim management system. Responsible for outside legal counsel assessments, RTW assignments, and evaluating medical case management strategies with nurse case managers and all other expert partners for necessity, effectiveness, and value. Demonstrate proficient knowledge and ability to apply case law to claim-handling practices. Evaluate the TPA for timely and accurate statutory/benefit payments within the established time frames and guidelines. Maintain a diary on all open claims. Document all relevant information to provide a clear history of events. Set review dates based on claim complexity or standard review criteria and report such to Management on a weekly basis. Exercise proper judgment and decision-making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim.Claims Manager Qualifications & Requirements Bachelor’s Degree from an accredited college or university preferred At least 3-5 years of TPA (preferably) or corporate experience handling workers' compensation claims. Active Alabama adjusting license preferred. Multi-state licenses are strongly preferred. Strong organizational, verbal, written, critical thinking, and problem-solving skills. Ability to work independently and deal effectively with multiple tasks simultaneously with minimal supervision. Ability to work under deadline pressures and effectively prioritize multiple tasks in a fast-paced environment. Demonstrated strong relationship-building, negotiating, and time-management abilities. Demonstrated ability to handle confidential information. Computer proficiency, including working knowledge of MS Office Product Suite, i.e., Word, Excel, PowerPoint, and TEAMS. Positive, professional demeanor, dependable and self-motivated.
Benefits Monthly Bonus Program Medical, dental and vision insurance 401K retirement plan Two weeks of vacation 8 Paid Holidays annually Life insurance
About Automation Personnel ServicesAutomation Personnel Services is an award-winning staffing agency with more than 30 years of experience in manufacturing and light-industrial staffing. Automation Personnel Services is the winner of the ClearlyRated® Best of Staffing Talent Award in 2019-2024, and the ClearlyRated® Best of Staffing Client Award for seven straight years, 2016-2024. Automation Personnel Services is also the recipient of the Safety Standard of Excellence Award by the American Staffing Association and was named one of the Best Staffing Companies to Work For 2022 by CIO Views Magazine.
Equal Opportunity EmployerAPSCorporate
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Vacancy caducado!