282655 - Workers Compensation Plant Rep III
- Post Date:December 14, 2021
- Apply Before: January 14, 2023
- Views 118
- Pay Rate 30.34
Act as the primary plant Workers’ Compensation claims handler through contact and coordination of robust RTW/Communications efforts with all stakeholders for the Company Workers’ Compensation program. Focus on excellent customer service, quality claims handling, and loss cost management • Primary Workers’ Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management.
Knowledge of WC and related claims handling including corporate, and industry best practices Knowledge of workers’ compensation RTW programs, standards, procedures/guidelines and expectations. Experience and/or knowledge in the use of duration guidelines Proven analytical skills Superior oral, written communications and interpersonal skills to be capable of dealing with all levels of personnel Ability to make prompt, intelligent decisions and recommendations based on detailed analysis of facts gathered. Good organizational and collaboration skills to effectively coordinate efforts among adverse and different internal and external parties. Contemporary knowledge and expertise in most Ford directed Claims functions and systems with particular expertise in providing strategies in the handling and servicing of claims
• Analyze and process complex or technically difficult workers’ compensation claims by investigating and gathering information to determine the exposure on the claim • Ability to handle a full case load, with proven ability to handle cases of increased severity. • Workers’ Compensation Lost Time claim handling experience • Manage claims through well-developed action plans to ensure timely and cost effective resolutions.
5+ years of workers’ compensation claims handling (best practices) experience or exposure ***Update need 5+ years of direct NY experience.*****
• Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. • Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams within designated authority level. • Prepare necessary state fillings within statutory limits. • Coordinate vendor referrals for additional investigation and/or litigation management. • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. • Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. • Report claims to the excess carrier. • Communicate claim activity and processing with the claimant and the client. • Ensure claim files are properly documented and claims coding is correct. • Refer cases as appropriate to supervisor and management. • Excellent oral and written communication skills. • PC literate, including Microsoft Office products. • Analytical and interpretive skills. • Strong organizational skills. • Good interpersonal skills. • Excellent negotiation skills. • Ability to work in a team environment.
College degree preferred. High School diploma with industry experience accepted
and 3 years of claims management experience or equivalent combination of education and experience preferred. • High school diploma and 3 years related claims experience accepted. • Appropriately licensed and/or certified in all states in which claims are being handled – Kentucky and New York. • Extensive knowledge of accepted industry standards and practices. • Computer experience with related claims and business software.
Additional Safety Training/Licensing/Personal Protection Requirements:
Additional Information :