Customer Service Agent, Dutch or Flemish Speaker
Triskel Consulting
Claims Manager I, Workers' Compensation
Sedgwick
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $73,456 - $102,838 per year
Job Level
Mid-LevelSenior
About the role
- Supervise multiple teams of examiners and technical staff for workers' compensation clients
- Monitor colleagues' workloads, provide training, and monitor individual claim activities
- Provide technical/jurisdictional direction to examiner reports on claims adjudication
- Maintain diaries on claims including frequent diaries on complex or high exposure claims
- Identify and advise management of trends, problems, and recommended courses of action
- Coordinate with management on projects and continuous process improvement
- Compile, review and analyze management reports and take appropriate action
- Perform quality review on claims in compliance with audit and service contract requirements
- Act as second level of appeal for client and claimant issues and implement final dispositions
- Review reserve amounts on high cost claims and claims over examiner authority
- Monitor third party, litigated, vocational rehabilitation, questionable and sensitive claims
- Maintain contact with clients and provide written resumes of specific claims as requested
- Assure direct reports are properly licensed in jurisdictions serviced and that files are coded and documented correctly
- Support the organization's quality program(s)
- Administer personnel policies, interview, hire, establish development plans, and conduct performance discussions
- Provide leadership, support, guidance and motivation to promote maximum performance
Requirements
- Six (6) years of claims experience or equivalent combination of education and experience
- Two (2) years claims supervisor experience
- Bachelor's degree from an accredited college or university preferred
- Licenses as required
- Professional certifications as applicable to line of business preferred
- Thorough knowledge of claims management processes and procedures for multiple product lines
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Leadership/management/motivational skills
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Credit security clearance, confirmed via a background credit check, required
