Risk Manager - Claims

JB Poindexter
  • Houston, TX
  • Autofill and Review
15 days ago

Job Description

Position Overview:Reporting to the JBPCO Claims Manager, the Claims Manager will be responsible for driving optimum claims outcomes, supporting operational goals and business objectives and providing customer service to our stakeholders. This position will oversee the third-party administrator (TPA) and work with adjusters on claims evaluations, strategy, reserves, legal, and review(?); ensure compliance with claims handling practices, statutes; lead claims reviews; interface with business units' EHS, nurses, and HR to obtain investigation reports and other information needed for the claims handling; communicate with attorneys on claims strategies and provide appropriate authority for claims settlements; oversees allocated claims expenses(?).Duties and Responsibilities:• Comprehensive Claims Oversight- Manage claims filed against the assigned business units and insurance lines. Follow standardized procedures for filing, tracking, and resolving claims.• Mediation Participation & Litigation Management- Participate in mediations as appropriate to provide expert representation and negotiation on behalf of the organization. Work closely with legal to develop strategies for effective claim resolution.• Financial Management- Monitor and analyze financial data to identify cost-saving opportunities and appropriateness of costs.• Workers' Compensation Management- Oversee and manage all workers' compensation claims, ensuring timely processing and resolution.- Oversee return-to-work programs to facilitate the prompt and safe return of injured team members.- Coordinate with healthcare providers, team members, and supervisors to manage recovery plans and accommodations.• Efficiency and Resolution- Implement best practices to resolve claims efficiently and effectively.- Manage metrics and KPIs to measure performance and improvement in claims management.• Regulatory Compliance- Ensure claims are managed in compliance with relevant statutes and regulations.- Maintain up-to-date knowledge of changes in claims management legislation.• Other Responsibilities - ensure compliance with claims handling practices, statutes and laws; participate in claims reviews; interface with business units' EHS, nurses, and HR functions to obtain investigation reports and other information needed for the claims handling; oversee and provide assistance with claims; communicate with attorneys on claims strategies and provide appropriate authority for claims settlements. This bullet point is redundant as most everything has already been stated, almost verbatim, previously in the description.Qualifications and Skills:• Bachelor's degree in related discipline• 10+ years experience adjusting and/or managing workers' compensation claims. Experience with auto and general liability claims a plus.• Familiarity with multi-jurisdictional adjusting and legal requirements• Experience with RMIS systems and general Microsoft software• Superior communication, strategic thinking and problem-solving skills

Numbers & Facts

LocationHouston, TX

Skills

  • Best Practicesunmatched
  • Claims Managementunmatched
  • Claims Processingunmatched
  • Cost Controlunmatched
  • Customer Support/Serviceunmatched
  • Expense Allocationunmatched
  • Expense Trackingunmatched
  • Financial Analysisunmatched
  • Financial Managementunmatched
  • Healthcare Providersunmatched
  • Insuranceunmatched
  • Investigative Reportsunmatched
  • Legalunmatched
  • Litigationunmatched
  • Maintain Complianceunmatched
  • Metricsunmatched
  • Microsoft Product Familyunmatched
  • Negotiation Skillsunmatched
  • Nursingunmatched
  • Operational Supportunmatched
  • People Managementunmatched
  • Performance Managementunmatched
  • Performance Metricsunmatched
  • Problem Solving Skillsunmatched
  • Regulationsunmatched
  • Regulatory Complianceunmatched
  • Regulatory Requirementsunmatched
  • Risk Managementunmatched
  • Strategic Planningunmatched
  • Time Managementunmatched
  • Worker's Compensationunmatched

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