Location
Columbus, OH | United States
Job description
Account Manager/Claims Specialist
Workers’ Compensation Services
Permanent Opportunity; $55,000k-$65,000k+ (DOE)
Monday-Friday, 8:00am-5:00pm
Columbus, Ohio
What the position offers:
- Working to ensure manufacturing competitiveness in Ohio is our only business!
- Hours are 8:30am - 5:00pm (1 hour lunch- 7.50 hr. day and a 37.50 work week)
- Employees are paid on the 15th and end of the month
- Medical + Dental + Vision insurance is available. Insurance is effective by date of hire; however, the paperwork takes 7-14 days to process and get in the system
- Paid parking
What you’ll be doing:
- Claims Management (apply process management as appropriate to companies’ state fund accounts vs. its self-insured accounts)
- A complete investigation of all new workers' compensation claims reported by company members for compensability and appropriate management strategy
- Monitor existing/ongoing claims activity with employers for safe return-to-work practices and adjust claim management strategies as conditions warrant
- Correspond with medical professionals to obtain appropriate and relevant medical documentation
- Prepare claims for all scheduled hearings at all Industrial Commission (IC) administrative levels
- Review hearing strategies with legal counsel to ensure effectiveness and the greatest potential benefit for employers
- Review claims for settlement potential, and financial rationale, and manage the required processes
- Research and manage cost savings strategies to minimize financial impact on employer premiums (i.e., handicap reimbursement)
- Refer claims to licensed private investigators when there is suspicion of fraud
- Act as a liaison and advocate on behalf of the employer between BWC and legal representatives
- Ensure compliance with all workers' compensation regulations and keep abreast of changes to laws, policies, and practices
- Participate in company work groups that implement or improve work processes and customer experience
- Suggest enhancements to the proprietary software application and processes to improve productivity and customer service outcomes
- Maintain and promote client relations via account visits and telephone conferences
- Prepare reports and management decision-making tools for employer clients
- Provide consulting in support of sales/retention and customer service
- Consult on compliance, program eligibility, claim strategies, BWC manual classifications, payroll reporting, and BWC products and programs
- Provide sales support to win and retain business
- Provide support to operations staff to timely execute joint operations
- Support member Customer Relationship Management (member outreach) program to improve member satisfaction
Who we’re looking for:
- Problem-solving and customer care
- TPA (Third Party Administrator) experience would be better than MCO (Managed Care Organizations) experience
- BWC rules/laws/policies and operational practices and processes within the Ohio workers' compensation system
- Claims management protocols and best practices
- General knowledge of the BWC rate-making process
- Organizational skills: ability to manage many multiple accounts and tasks
- Excellent customer service skills and communication skills, written and verbal
- Knowledge of Microsoft Office
**Send qualified resumes to [email protected]!**
Job tags
Salary
