Workers Compensation Manager

Position Summary

Manages severe loss claims within company standards and best practices. Processes workers compensation claims, conducting investigations and coordinating with carrier and internal legal team as appropriate. Reviews compensable issues and determines dispositions including continuance or denial of cases within scope of authority. Tracks and monitors claims occurrences. Identifies opportunities to address safety issues and provides recommendations based on supporting analysis of claims activity. Works to oversee claims management for East or West division of the company across multiple verticals within the business.

Essential Duties and Responsibilities

Job responsibilities include but are not limited to:

Claims Management

Provide Senior level claims management of severe claims arising from a defined region of the business
• Conduct and oversee workers compensation claims management for the East or West division of the company.
• Receive and manage referred serious or time loss cases and complete Initial Claim intake and investigation.
• Complete OSHA Recordability Determination and update in Salesforce.
• Work with supervisor/employee to address modified duties and document interactive reasonable accommodation process in Salesforce.
• Conduct and document employer level investigation and determine compensability and coordinate with Regional Safety Manager to identify safety violations to Safety based on policy or Corrective/Preventative (CAP) Measures.
• Prepare offer of modified duty letters, regulatory WC forms and authorization of treatment.
• Process and coordinate with Benefits work related Leaves of Absence.
• Complete wage statements and conduct discovery.
• Assign Defense Attorney as appropriate with full litigation and claim resolution within authority.
• Complete Interactive Process when injured worker is assigned permanent work restrictions.
• Provide claims concurrence for claim dispositions (Accepted/Delayed/Denied).
• Maintain Diary for follow up on claims to ensure Claim Professional with Third Party Administrator is on top of their tasks, working claims to early resolution, and or closure.
• Analyze and approve reserve increase recommendations and settlement concurrence up to $100,000 Total Incurred; consult with Director if request is in excess of authority.
• Participate in Quarterly Claim Reviews, Annual Stewardship and Partnership Meetings

Program Management
• Track and conduct analysis of claims data and assess and recommend safety training opportunities.
• Review claims processes to determine and recommend changes to process, including technology integration to streamline and increase efficiencies.

Regulatory adherence, documentation and reporting
• Comply with federal, state and local legal requirements by being knowledgeable of existing and new legislation, ensuring adherence to requirements and advising management on needed action.
• Execute and maintain OSHA-related regulatory programs and documentation.
• Review accident investigations, injuries, and OSHA logs; analyze and determine trends.
• Identify opportunities to bring greater awareness and/or training to the safety team and work with team to track effectiveness of safety training.

Relationship management
• Work with insurance administrators to ensure effective coordination, along with efficient and full use of applicable resources.
• Work with insurance carriers, legal and risk management team to continuously improve on processes to bring greater efficiencies.
• Support Director of Risk Management in reviewing and updating the overall claim management and safety training strategy.

Additional key responsibilities
• Effectively handle information and reports while maintaining the strictest confidentiality.
• Manage regular preparation of relevant management reports, including weekly, monthly, quarterly and year-end reports.
• Respond to worker's compensation questions from company leadership, former employees, insurance carrier, claims administration vendors, representatives and government agencies in a timely manner.
• Properly document and maintain worker's compensation claims activities, documents, interactions and related materials in designated applications.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, or participating in professional societies.

Additional Duties and Responsibilities

Perform other related duties as required and assigned.

Knowledge, Skills and Competencies

Knowledge:
• Must be bilingual with ability to read and write in Spanish
• Proficiency in OSHA General Industry standards, state safety statutes and local municipal regulations.
• Claim process management; loss prevention strategy.
• Management across multifunctional, multi-vertical large business in service industry (providing retail, hospitality, institutional and commercial cleaning, building custodial and landscaping services).
• OSHA certification preferred, but not required; may complete within first year of employment, general administration, compliance and reporting.
• Safety program(s) development and delivery (training and communications).
• TPA and other insurance program coordination.
• Industry specific safety training; chemicals, equipment use and repairs, procedures for performing labor and related safety measures.
• Data review and analyses.
• Facilities and building maintenance services industry.

Skills:
• Ability to anticipate and mitigate potential issues.
• Organization, planning and priority setting skills.
• Accurate and clear communications (oral and written) including phone demeanor and presentation skills.
• Detail oriented with ability to discern and communicate the facts that support and motivate actions required to address risk.
• Ability to work with and communicate with all areas of the business and levels of management.
• Training and education delivery (communication and safety program development and delivery skills).
• Strong analysis and assessment skills.
• Investigation and documentation skills.
• Time management with sense of urgency for time critical issues.
• Bilingual in English and Spanish.
• Microsoft Office programs to include, but not limited to Word, Excel, PowerPoint and Outlook.

Competencies:
• Interpersonal savvy.
• Builds integrity and trust.
• Agile; able to shift priorities in the face of changes.

Educational Qualifications/Job Experience Requirements

Experience Required: 10 years direct experience managing workers compensation claims across for large companies managing claims associated with severe loss. Claims management experience in industrial and or chemical cleaning, building and or landscaping where operation of equipment and proper handling of tools and chemicals is essential.

Education: Bachelor's degree in business or risk management-related field or equivalent experience.

Working Conditions/Physical Requirements

Schedule:
• Regular weekly schedule; weekends or holidays as needed.

The working conditions and physical environments 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 requirements:
• Extended periods of work seated at a desk; repetitive hand motions; prolonged use of computer
• Ability to speak clearly (use of voice).
• Vision requirements include close vision, distance vision, moderate peripheral vision, depth perception and ability to adjust focus.

Environment:
• Office environment generally mild to moderate conditions including varying temperatures and noise levels conducive to a busy workplace and office equipment.
• Lighting varies based on building requirements and may be adjusted within reason.
• Time constraints and related pressures to complete work are high.

Travel: