Workers Compensation Administrator II administers the workers' compensation program for an organization. Implements a consistent process for recording, investigating, and reporting workers' compensation claims complying with laws and regulations. Being a Workers Compensation Administrator II prepares and submits required reporting and documentation to OSHA, state and local agencies, and other entities. Monitors all claims and liaises with the employees, managers, insurance representatives, union representatives, medical staff, and attorneys involved with a case. Additionally, Workers Compensation Administrator II communicates case status details and necessary information to involved parties, including notifications of hearings, outcomes, return to work, or restrictions. Performs periodic reviews of overall cases to identify trends. Maintains up-to-date knowledge of all regulations and laws for reporting workers' compensation. May coordinate or assist with safety programs focused on injury prevention or facilitate accommodations for workers. May require a bachelor's degree. Typically reports to a manager. The Workers Compensation Administrator II occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Workers Compensation Administrator II typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)
Division: | Turner Surety & Insurance Brokerage |
Project Location(s): | Dallas, TX 75201 USA |
Minimum Years Experience: | 8 |
Travel Involved: | |
Job Type: | Regular |
Job Classification: | Experienced |
Education: | |
Job Family: | Insurance and Claims |
Compensation: | Salaried Exempt |
Position can be performed from any office location or remotely from home.
Position Description: Oversee insurance carriers and Third-Party Administrators (TPAs) in their management and handling of clients’ Workers’ Compensation claims in the Texas, Oklahoma, Missouri, Kansas, Iowa, Nebraska, and Ohio geographic regions based on program and compliance regulations.
Essential Duties & Key Responsibilities:
· Oversee assigned workers’ compensation case portfolio of minor to complex claims in the Central and California geographic regions.
· Leverage knowledge of workers’ compensation policy and Manage incidents , and dispatch nurse case managers as necessary.
· Collaborate closely with Risk Management leadership on workers’ compensation claims, process, and procedures to ensure integrated program.
· Serve as resource for injured employees and inform of workers’ compensation process and procedures.
· Report workers’ compensation claims to carriers and Third-Party Administrators (TPAs), including notification of questionable claims.
· Facilitate proactive identification of claims with opportunities for early Return to Work and light duty Return to Work program, as needed.
· Evaluate and respond to Reserve and Settlement Consultations within given authority, escalate consultations above scope authority to appropriate leadership.
· Maintain diary for open claims and document specific claim related activities in Risk Management information system.
· Work with carriers, TPAs, and Defense Counsel to develop mitigation strategies for Owner Controlled Insurance Program (OCIP) that result in cost savings to the claim, ensure aggressive strategy is developed on litigated claims, and bring claims to timely resolution.
· Collaborate with General Liability team to develop mitigation strategies and facilitate most economic global resolution of Contractor Controlled Insurance Program (CCIP) claims.
· Attend hearings and mediations on as needed basis.
· Ensure avenues for potential claim recovery are identified and pursued and manage lien recovery on case by case basis.
· Participate in claims review process and monitor claims handling process by carriers and TPAs provide direction to ensure compliance with best practices and special handling instructions.
· Oversee and hold vendors and defense firms accountable for adherence to standard protocols, agreed to service instructions, and litigation management guidelines. Update instructions and guidelines and provide recommendations to appropriate leadership.
· Partner with Safety team and onsite medics on initiatives that support worker wellness and post-injury care.
· Participate in CCIP kickoff meetings and jobsite walkthroughs, attend Claims, Safety and Operations meetings to monitor current and anticipated project risks and report on claims status for specific projects.
· Maintain and foster relationships with carriers and TPAs claims teams.
· Assist with claim data analysis and claim performance reports.
· Collaborate with HR and Payroll departments for completion of required Workers’ Compensation Jurisdictional Forms.
· Support audits related to workers’ compensation claims.
· Remain current on Workers’ Compensation laws and regulations, industry trends, and case law within assigned jurisdictions.
· Other activities, duties, and responsibilities as assigned.
Qualifications:
· Bachelor Degree in Insurance, Risk Management, Finance, Business Administration or related program; with minimum of 8 years of workers’ compensation claims administration experience in Texas, Oklahoma, Missouri, Kansas, Iowa, and Nebraska jurisdictions; or equivalent combination of education, training, and/or experience
· Experience with workers’ compensation claims in a construction environment, desired
· CRIS, ARM or similar insurance designation, desired
· Knowledge of jurisdictional laws and regulations
· Knowledge of regional state Labor Laws, a plus
· OSHA 30-hour certification, a plus - OSHA knowledge or experience
· Demonstrate process thinking and sound decision-making skills
· Analytical and adept at processing and breaking down data into actionable information
· Self-starter with strong project management skills and capable of managing concurrent complex projects and tasks successfully to completion
· Demonstrate strong interpersonal and teamwork skills with ability to work with individuals across organizational levels, both internal and external
· Professional written and verbal communication, and effective presentation skills
· Proficient in computer skills, Microsoft suite of applications, MS Outlook, and insurance-based risk management information systems
· Limited travel
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, use hands to finger, handle, or feel objects, tools, or controls; and reach with hands, talk, and hear. The employee frequently views a computer monitor and frequently uses a computer keyboard. Specific vision abilities required by this job include close vision, peripheral vision, depth perception, and the ability to adjust focus. The employee is occasionally required to be mobile and the employee occasionally travels both short and long distances via a variety of conveyances. The employee occasionally performs work on-site at construction work sites, office locations, and/or off-site venues. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee regularly works in an office setting. The noise in the work environment is usually quiet to moderate in an office setting. While performing the duties of this job, the employee may occasionally work at construction work sites where the employee is exposed to moving mechanical parts, high precarious places, fumes or airborne particles, outside weather conditions, and risk of electrical shock. The noise in the work environment is usually moderate to loud. The employee is required to work in compliance with company safety policies, procedures, and applicable laws.
Turner Surety and Insurance Brokerage, Inc. is an Equal Opportunity Employer
Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
VEVRAA Federal Contractor
Turner is an Affirmative Action and Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.
VEVRAA Federal Contractor