Workers' Compensation Claims Manager jobs in New Mexico
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)
Recently Added Workers' Compensation Claims Manager jobs
Workers Compensation Claims Representative I
- AMERIND
-
Santa Ana, NM
FULL_TIME
-
Position Characteristics and CompetenciesProblem-solving and analytical thinking
- Strong verbal and written communication skills
- Interest in discovering and developing new ideas
- Service and people oriented
- Agile and adaptable in decision making
- Transparent and interactive in projects and reporting
- Trustworthy as a company rep; forthcoming, communicative, and people-oriented
Job SummaryIncumbent handles Tribal Workers’ Compensation claims. Responsible for all technical aspects of claim management for assigned files including compliance with the AMERIND Risk Benefit Endorsement, Tribal Ordinances (when applicable) and all established performance guidelines. Caseload will consist of medical only claims and less complicated loss time claims. Should also have familiarity with general claims handling software. This individual demonstrates positive and professional relationships with Members, Brokers, and clients.This job description does not represent an inclusive list of all duties encompassed in this position.Job Responsibilities- Interacts with customers and associates over the telephone, in person, and in written correspondence to establish and improve communication and service capabilities.
- Properly investigates and handles workers’ compensation files including medical only claims and less complicated loss time claims within predetermined claim-handling guidelines.
- Takes initial calls and provides instructions on claim filing requirements.
- Initiates return-to-work discussions with the employer and effect return-to-work for the injured worker on lost time claims.
- Interviews claimants, specialists, witnesses, physician or other professionals as necessary.
- Determines compensability and total value of claim; negotiate settlements and make recommendations regarding litigation.
- Establishes timely and appropriate case reserves.
- Investigates and manage subrogation and negotiate settlements.
- Interacts and consults with attorneys and other providers regarding claims to control costs and assist in making decisions and actions.
- Negotiates directly with the claimants as necessary.
- Uses automated diary system to issue indemnity benefits and provide claim management.
- Accurately calculates and pays wage loss and other benefits on lost time claims.
- Reviews and follows up on claims as needed, and closes files as appropriate.
- Documents all action plans and evaluations for claim resolution.
- Maintains organized electronic files.
- Addresses customer complaints and inquiries in an exemplary and professional manner.
- Achieves specific performance outcomes related to quality and quantity of work as established by management.
- Provides cost containment for individual claim and overall claim costs for account to achieve account profitability.
- Conducts in person claim reviews when scheduled or requested.
- Performs the duties noted in the position descriptions in accordance with AMERIND Risk WC Claim Handling Guidelines.
- Performs a wide variety of typing assignments which are sometimes confidential in nature; operates personal computer to enter data, draft, edit, revise, and print letters, tables, reports, and other materials.
- Maintains confidentiality of all information.
- Participates in cross-functional team process improvement projects.
- Performs other duties as assigned.
Supervision of OthersN/AMinimum Qualifications- Associate’s Degree in Insurance, Economics, Business Administration or related field
- Bachelor’s Degree in Insurance, Economics, Business Administration or related field preferred
- Two years basic insurance knowledge required
- Prior workers’ compensation claims handling experience preferred
- Valid Driver’s License
- Must be able to successfully pass a background investigation
Additional Eligibility Requirements- New employees must complete the Associate in Insurance (AINS) designation within six months from the end of the 90-day evaluation period to be eligible for advancement and incentive compensation.
- For continued employment, employees must complete an elective course and six hours of professional development within 12 months after the end of the 90-day evaluation period.
Knowledge/Skills/Abilities- Demonstrated working knowledge of workers’ compensation administration rules/laws and/or Tribal Work Comp experience preferred.
- Familiarity of technology infrastructure and user of technology tools
- Knowledge of medical and insurance terminology, and of claims processing practices.
- Ability to communicate effectively in the English language, both verbally and in writing.
- Ability to analyze situations and adopt appropriate courses of action.
- Ability to work effectively under stressful conditions.
- Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds, employees and officials.
- Ability to develop and interpret policies, procedures, and regulations.
- Ability to maintain an accurate and organized filing system of complex insurance records and reports.
- Ability to handle multiple tasks and meet deadlines.
- Ability to exercise independent judgment.
- Ability to train and present information to others.
- Ability to speak and present in claim reviews.
- Ability to follow oral and written instruction.
- Ability to collect and analyze data, and prepare and present accurate reports and recommendations.
- Skill in performing statistical and mathematical computations.
- Skill in preparing, presenting, reviewing, and analyzing insurance claims, forms, and reports.
- Skill in providing excellent customer service.
- Skill in operating business computer and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).
- Database management skills.
- Excellent telephone communication skills.
Working Conditions & Physical Demands- Typical business office setting with moderate noise level.
- Non-office environment may be encountered for offsite presentations and support of company activities.
- Must be able to sit for work at a computer and phone for more than 6 hours per day.
- Must be able to speak clearly.
- Must be able to use hands for dexterity of motion.
- Frequently required to stand, walk and reach with hands and arms.
- Must have ability to occasionally lift 20 lbs.
- Must be willing to travel as necessary which may require overnight stays.
Physical ExamEmployee is required to successfully pass an annual physical exam to certify that the incumbent is capable of performing the physical demands of the job as described above.
- 2 Days Ago
Workers' Compensation Claim Adjuster I (NM Claims) (Hybrid)
- CCMSI
-
Albuquerque, NM
OTHER
- Overview At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of ...
- 1 Day Ago
Clinical Manager
- United Energy Workers Healthcare
-
Grants, NM
FULL_TIME
- **We are offering a $2,000 Sign on Bonus** JOB TITLE: DIVISION: REPORTS TO: Clinical Manager Operations Area Director COMPANY: We are people who care about people. Our company has a unique history and...
- 15 Days Ago
COMPENSATION MANAGER
- Los Alamos County
-
Los Alamos, NM
FULL_TIME
- CLASSIFICATION: Exempt DEPARTMENT/DIVISION: County Manager’s Office/Human Resources SUPERVISOR: Human Resources Manager or designee Position Summary: Under general direction of the Human Resources Man...
- 20 Days Ago
COMPENSATION MANAGER
- ISLETA RESORT & CASINO
-
Albuquerque, NM
FULL_TIME
- The Compensation Manager is responsible for designing, implementing, and managing Isleta Resort & Casino’s compensation programs. The primary objective will be to attract, retain, and motivate employe...
- Just Posted
COMPENSATION MANAGER
- Sandia Resort And Casino
-
Albuquerque, NM
FULL_TIME
- Position Summary Under direct supervision of the Human Resources Director, supervises, administers and coordinates the compensation functions for all business entities. Has primary responsibility for ...
- 7 Days Ago
Workers' Compensation Claims Manager jobs at Popular Companies
Workers Compensation Claims Manager
- Intercare Holdings Insurance Services
-
Rocklin, CA
- Worker Compensation Claims ManagerJob Details Job Type Full-time Rocklin, CADescription Summary: Reports directly to the...
- 4/24/2024 12:00:00 AM
Workers Compensation Manager
- Muslusky Law
-
Las Vegas, NV
- Job Description Job Description The ideal candidate should have A minimum of 2 years of experience handling claims in a ...
- 4/23/2024 12:00:00 AM
Workers Compensation Claims Manager
- Intercare Insurance
-
Rocklin, CA
- Worker Compensation Claims Manager Job Details Job Type Full-time Rocklin, CADescription Summary: Reports directly to th...
- 4/22/2024 12:00:00 AM
Workers Compensation Claims Manager
- Intercare Holdings Insurance Services
-
Rocklin, CA
- Worker Compensation Claims ManagerJob Details Job Type Full-time Rocklin, CADescription Summary: Reports directly to the...
- 4/22/2024 12:00:00 AM
Workers' Compensation Manager
- Bolthouse Farms
-
Bakersfield, CA
- THE ROLE: This position will report to the: Director Health & Safety Location Bakersfield, CA FLSA Status: Exempt Employ...
- 4/22/2024 12:00:00 AM
Workers' Compensation Manager
- Bolthouse Farms
-
Bakersfield, CA
- THE ROLE: This position will report to the: Director Health & Safety Location: Bakersfield, CA FLSA Status: Exempt Emplo...
- 4/22/2024 12:00:00 AM
Workers' Compensation Claim Manager (In Office) - New England Claims
- CCMSI
-
Reading, MA
- Overview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Part...
- 4/21/2024 12:00:00 AM
Claims Review Specialist - Workers Compensation
- Aerotek
-
Tempe, AZ
- Aerotek has an immediate opening for a Claims Review Specialist - Workers Compensation at the corporate office in Tempe,...
- 4/20/2024 12:00:00 AM
About New Mexico
New Mexico (Spanish: Nuevo México Spanish pronunciation: [ˈnweβo ˈmexiko] (listen), Navajo: Yootó Hahoodzo pronounced [jòːtxó xɑ̀xʷòːtsò]) is a state in the Southwestern region of the United States of America; its capital and cultural center is Santa Fe, which was founded in 1610 as capital of Nuevo México (itself established as a province of New Spain in 1598), while its largest city is Albuquerque with its accompanying metropolitan area. It is one of the Mountain States and shares the Four Corners region with Utah, Colorado, and Arizona; its other neighboring states are Oklahoma to the north...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Workers' Compensation Claims Manager jobs
$78,695 to $101,661
Most Popular Cities in New Mexico for Workers' Compensation Claims Manager Jobs
What does a Workers' Compensation Claims Manager do?
Workers' Compensation Claims Manager in Raleigh, NC
During the interview As Workers Compensation Claims Manager process employers will want to find out how you respond to supervision.
January 14, 2020
Workers' Compensation Claims Manager in Long Beach, CA
Where do you see your career in five years As Workers Compensation Claims Manager.
February 05, 2020
Workers' Compensation Claims Manager in Tuscaloosa, AL
Some of this is within the control of claims and defense counsel, and much isn't.
February 12, 2020