Workers' Compensation Claims Manager manages accountabilities in the administration of first and third party worker's compensation claims. Manages domestic and/or international claim management strategies critical to the organization's success. Being a Workers' Compensation Claims Manager is responsible for reporting, investigation, and analysis; litigation management; resolution/outcome management; and the delivery of claim information. Manages litigated and moderately complex claims and is entrusted with significant settlement authority. Additionally, Workers' Compensation Claims Manager creates and develops relationships with claims adjusters, insurers, outside legal counsel, and other claims related parties. Directs workers' compensation claims policies and procedures within the claim information analysis. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Workers' Compensation Claims Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Workers' Compensation Claims Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
The City of Boise is driven by a team of over 2000 community-serving superheroes, across 13 departments, working together to create a city for everyone. Committed to the limitless potential of our organization, we strive to recruit good people, set a standard of excellence, and develop leaders. Our Human Resources Department is recruiting an experienced and team-oriented Workers Compensation Lead Claims Administrator to support our incredible growing workforce.
We're seeking a person with excellent communication and customer service skills, who operates with tact and discretion, to keep stakeholders informed throughout the employee's recovery process. The Workers Compensation Lead Claims Administrator:
Coordinates day-to-day work, delegates tasks and sets deadlines for the assigned team. Provides guidance, direction and support for training and reviews work. Ensures effective collaboration with other teams and listens to team members’ input, provides feedback and resolves any issues or conflicts.
Serves as the primary point of contact and decision-maker for the city's workers' compensation program. Serves as the liaison between the city, third-party administrators (TPA), employees, in-house and contract attorneys and the State of Idaho Industrial Commission. Processes and oversees claims administered by TPAs and works with TPAs on investigations. Authorizes payment on workers’ compensation claims.
Analyzes accident statistics and formulates corrective actions. Consults with departments and legal staff regarding health and medical issues. Ensures compliance with all local, state and federal regulations. Coordinates with city departments and medical providers to ensure timely rehabilitation and work resumption of injured employees. Ensures the maintenance of accurate, up-to-date records and reports on injured employees.
Assists in handling self and commercial insurance issues and liability claims. Acts as a backup manager for the city's comprehensive liability program by assisting with third-party liability claims programs. Works closely with risk managers, attorneys and TPAs to evaluate claims and formulate appropriate responses and resolutions.
Liaises with the city's insurance carriers, insurance brokers, inspectors, underwriters, TPAs and property valuators to acquire appropriate insurance and administer claims. Manages team contracts and reviews requests for proposals (RFP), contracts and other agreements for appropriate indemnification and insurance information. Reviews special event plans for risks and works with event coordinators to mitigate unacceptable risks. Reviews and approves event insurance levels and indemnification language.
Completes investigations of incidents, workers’ compensation claims, third-party claims, issues, damages and accidents. Analyzes findings, resolves issues, provides recommendations to prevent future occurrences and writes and reviews reports identifying all pertinent facts. Identifies potential health and safety risks to determine corrective action. Develops, implements and monitors the city's health and safety programs. Researches issues, standards and legislation concerning workers’ compensation, health and safety.
Develops training for city supervisors and city employees. Consults with local healthcare professionals regarding public safety and health issues, infectious disease control and blood-borne pathogens. Serves as the designated officer to manage post-exposure programs and infectious disease tracking. Analyzes work environment hazards, identifies needs and sets standards for personal protection equipment.
Performs other duties as assigned. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this position at any time.
Required Knowledge, Experience, And Training
A combination of education and/or experience typically achieved through:
Valid state-issued driver's license.
Ability to: acquire the Idaho Industrial Commission designation Certified Idaho Workers’ Compensation Specialist- Advanced Level; and obtain certification to instruct various safety and health-related education classes, such as First Aid/CPR and AED, Defensive Driving and others within the 1st year.
The physical effort characteristics and working environment 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.
Physical Efforts
While performing the duties of this job the employee is occasionally lifting/carrying up to 10 pounds. Also, the employee is occasionally pushing/pulling up to 10 pounds. The noise level is occasionally moderate and rarely very loud. Work includes sensory ability to talk, hear, smell and touch. Work in this position also includes close vision and distance vision. Employees will sit, stand, walk, stoop, kneel, crouch, crawl, reach, grasp, climb and balance. Position requires hand/finger dexterity.
Working Environment
The work environment will include inside conditions, outdoor weather conditions, extreme temperatures, in wet and humid conditions, areas of dust, odors, mist and gases or other airborne matter. Employees will also drive a vehicle as part of this position. Work includes protected exposure to bodily fluids and chemicals. Navigates a variety of walking surfaces, including but not limited to uneven surfaces, slippery surfaces, stairs, areas under construction. At times exposed to unpleasant odors and environments, reduced air quality, hazardous chemicals and infectious substances.
This position works: normal business hours, but must respond to call-ins when accidents and injuries occur.
Top talent deserves top-notch benefits. The City is among the best in the Treasure Valley when it comes to the benefits and perks we offer our employees.
Most positions are eligible for the general benefits listed here; firefighters, police officers, senior managers, command staff, and directors may be offered other benefit plans.
Healthcare: