FULL_TIME

FEED

UNKNOWN

About the Role: Responsible for IOA insurance Claims Management activities including: client advocacy, service and communication, problem claim resolution, data analysis and action, monitoring triggered activities, claims reviews and audits, workers compensation claim oversight, reserve analysis, unit stat and stewardship reporting, client education and consulting, sales support, litigation process management, new client onboarding, intake process support, data management and entry, and Producer communication. Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity.

YEAR

DescriptionJob Description:Title: Claims Advocate – Risk ServicesFully remote | Experience/Book Focus: Commercial Auto, Trucking, Transportation, Property Cargo   Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity. Additionally, there may be occasions when on-site presence is necessary to meet specific business needs. Learn more about our locations here: <a href="https://ioausa.com/locations/" rel="nofollow noopener noreferrer" target="_blank">ioausa.com/locations</a> About the Role: Responsible for IOA insurance Claims Management activities including: client advocacy, service and communication, problem claim resolution, data analysis and action, monitoring triggered activities, claims reviews and audits, workers compensation claim oversight, reserve analysis, unit stat and stewardship reporting, client education and consulting, sales support, litigation process management, new client onboarding, intake process support, data management and entry, and Producer communication.   Key Responsibilities: <ul><li>Performance Standards: Meet all production, quality, and service expectations. </li></ul><ul><li>Client Service Excellence: Deliver outstanding service by anticipating client needs and responding promptly. </li></ul><ul><li>Client Advocacy: Serve as a dedicated advocate, providing high levels of ongoing support and consultation. </li></ul><ul><li>Problem Claim Resolution: Manage complex or delayed claims to ensure timely and favorable outcomes. </li></ul><ul><li>Loss Report Analysis: Review aggravated inequity loss reports and take appropriate corrective actions. </li></ul><ul><li>Activity Monitoring: Track triggered claim activities and implement necessary follow-up actions. </li></ul><ul><li>Claims Review & Auditing: Conduct and participate in formal claims reviews and audits. </li></ul><ul><li>Workers Compensation Oversight: Monitor workers compensation claims via the IOA Claims Portal and drive them to closure. </li></ul><ul><li>Reserve Accuracy: Perform reserve analysis to ensure timely and accurate case reserves in line with best practices. </li></ul><ul><li>Carrier Relationship Management: Build and maintain strong relationships with carriers to influence positive claim outcomes. </li></ul><ul><li>Claims Mediation: Act as an intermediary between clients and carriers to facilitate effective and timely resolutions. </li></ul><ul><li>Client Education: Provide ongoing education on statute changes, state-specific procedures, and claims best practices. </li></ul><ul><li>Trend Identification & Risk Mitigation: Identify claims trends, recommend risk mitigation strategies, and collaborate with Risk Advocates. </li></ul><ul><li>Sales Support: Assist with Producer presentations and contribute to sales efforts through claims insights. </li></ul><ul><li>Reporting & Documentation: Prepare and deliver stewardship and unit stat reporting in accordance with departmental standards. </li></ul>  Ideal Candidate Qualifications: <ul><li>5+ years of claims handling experience; preferred experience in an agency advocate or liaison role </li></ul><ul><li>Licensed Insurance Adjuster or state equivalent </li></ul><ul><li>Exceptional customer service, communication, multi-tasking, organizational, delegation, and decision-making skills </li></ul><ul><li>Ability to perform large work volumes with high accuracy </li></ul><ul><li>Proficiency in MS Office (Outlook, Word, Excel) </li></ul><ul><li>High School Diploma (or equivalent) </li></ul>  What We Offer: <ul><li>Competitive salaries and bonus potential </li></ul><ul><li>Company-paid health insurance </li></ul><ul><li>Paid holidays, vacations, and sick time </li></ul><ul><li>401K with employer match </li></ul><ul><li>Employee stock plan participation </li></ul><ul><li>Professional growth and career progression opportunities </li></ul><ul><li>Respectful culture and work/family life balance </li></ul><ul><li>Community service commitment </li></ul><ul><li>Supportive teammates and a rewarding work environment </li></ul>  What to Expect (Application Process): <ul><li>30-Minute Phone Screen, Online Assessments, and Interview(s) </li></ul>Salary Rangehe expected pay range for this position is $70,000 to $95,000 per year, depending on experience, relevant skills, and geographic location.Insurance Office of America is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Insurance Office of America

Claims Advocate - Risk Services (Trucking/Transportation)

Analysis Skills

Auditing

Best Practices

Cargo/Freight

Claims Management

Claims Processing

Consulting

Corporate Policies

Corrective Action

Customer Support/Service

Data Analysis

Data Entry

Data Management

Data Processing

Diversity

Documentation

Health Insurance

Insurance

Insurance Claims

Litigation

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft Word

Multitasking

Onboarding

Problem Solving Skills

Process Management

Relationship Management

Risk

Risk Analysis

Risk Management

Sales

Sales Management

Sales Support

Service Delivery

Stewardship

Stock Purchase Plans

Time Management

Trend Analysis

Trucking

Worker's Compensation

Jobvite Talemetry Organic Easy Apply

OTHER

In addition, the Social Services Supervisor carries a caseload and provides direct practice interventions, organizes and implements social work services to an assigned caseload of participants and their caregivers in accordance with InnovAge policies and all applicable regulations. Responsibilities include, in partnership with the Social Services Manager, interviewing and training employees; planning, assigning, and directing work; appraising performance; recognizing and rewarding employees; supportive coaching, addressing complaints and resolving problems.

Responsibilities:
The Social Services Supervisor provides on-site leadership and clinical support to their assigned center’s MSW team.  This includes general oversight of psychosocial services delivered to InnovAge PACE Participants and family members.  In addition, the Social Services Supervisor carries a caseload and provides direct practice interventions, organizes and implements social work services to an assigned caseload of participants and their caregivers in accordance with InnovAge policies and all applicable regulations. Conducts psychosocial assessments, participates in care planning and acts as a liaison between the participant and the interdisciplinary team.    Essential Functions and Work Responsibilities Functional Category: Client CareEstimated Percent of time Spent – 20%Assessment and Care Planning<ul><li>Social Work Supervisor will carry a 1:30 participant panel of complex cases that require advanced reasoning and experience.</li><li>Performs initial assessments of PACE participants to obtain a psychosocial history including cognitive status, mental health and substance use history, behavioral concerns, family dynamics, and current social supports. </li><li>Participates within the interdisciplinary team in the formulation of Plans of Care for InnovAge PACE program participants, as well as in other interdisciplinary team settings that plan, coordinate and monitor the care of InnovAge PACE program participants.</li><li>Conducts in-person reassessments of enrolled participants every six months or as determined by policy and best practice. Assessments include collaboration with caregivers and assessment of housing risk.</li><li>Completes home visits at least annually and as needed to work proactively with participant, IDT, and community partners to maintain the participant’s functioning as independently as possible in their community.</li></ul>Case Management<ul><li>Develops collaborative relationships with internal and external partners.  Utilizes a solution-oriented perspective to facilitate resolution of participant needs.</li><li>Engage with CCT team, including Chaplain, CCT nurse and PCP for end-of-life support and coordination</li><li>Facilitates, mediates and documents participant care conferences, family meetings and facility partnership meetings.</li><li>Actively and assertively manages respite and hospital length of stay.  Collaborates with participants, caregivers, facilities and the IDT to ensure clear communication regarding participant status and plan.</li><li>Works in collaboration with hospital discharge planners, primary care, IDT, families and caregivers regarding participant’s disposition from the hospital.  Partners with the InnovAge Mental Health Team when hospitalization is psychiatric. </li><li>Provides referrals to and coordinates assessments with contracted facilities.  Supports the participants in the tour and move planning process as clinically indicated.</li><li>Completes Pre-Admission Screen and Resident Review (PASSR) for all nursing home admissions from the community.</li><li>Partners with the Innovage Medicaid Department to assist the participant in keeping resources within the guidelines of Medicaid eligibility and supports the recertification process.</li><li>Advises the participant or financially responsible party about housing co-pays and notifies the Medicaid department of the need to generate a Supportive Housing Form.</li><li>Supports the inter-center transfer process for participants who move between catchment areas, relaying participant history and care plan issues to the receiving social worker.</li><li>Provides referral support to community resources and participates in inter-agency coordination of care.</li><li>Proactively supports the participant grievance process, involving the Center Director in all potential voluntary disenrollments due to dissatisfaction.  </li><li>Assists participants who are disenrolling with transition to outside services, including timely referral back to the single entry point and completion of disenrollment paperwork.</li><li>Maintains accurate and timely documentation and paperwork including participants’ electronic medical records according to policies and procedures.</li><li>Attends and actively participates in IDT meetings, Social Services department meetings, Cross Sites and Annual Competencies.</li></ul>Psychosocial Support<ul><li>Monitors changes in the patient's condition and needs.</li><li>Assists physician, or intermediate care provider, and other team members in understanding the significant social and emotional factors related to the health problems.</li><li>Provides psychosocial services in accordance with established standards.</li><li>Evaluates quality of psychosocial services provided and adjusts interventions as clinically indicated.</li><li>Schedules home visits as necessary according to patient needs.</li><li>Acts as a resource to other team members and staff regarding topics such as dementia, difficult behaviors, and difficult personalities. Supports the IDT in establishing behavior management plans.</li><li>Strive for continuous growth and development of Cultural Competency exhibiting an understanding, awareness, and respect for diversity.</li><li>Performs other duties as assigned.</li></ul>Functional Category: SupervisionEstimated Percent of time Spent – 40%<ul><li>Provides leadership and direction to members of their designated centers Social Services team.</li><li>Carries out leadership responsibilities in accordance with the organization's policies and applicable state and federal employment laws.</li><li>Responsibilities include, in partnership with the Social Services Manager, interviewing and training employees; planning, assigning, and directing work; appraising performance; recognizing and rewarding employees; supportive coaching, addressing complaints and resolving problems.</li><li>Ensures annual employee performance reviews are conducted in a timely and effective manner in partnership with the Social Services Manager.  Evaluates performance of employees for compliance with established policies and objectives of the organization and contributions in attaining objectives.</li><li>Helps set the tone of the department to ensure morale, teamwork, and that the positive employment culture of the organization is maintained. Schedule department, and staff 1:1 meetings as appropriate to provide leadership, development, and a forum for communication to ensure coordination and collaboration in meeting organization and individual goals.</li></ul>Functional Category: AdministrationEstimated Percent of time Spent – 40%<ul><li>Assists with implementation of policies and procedures for their assigned Social Work team in collaboration with the Social Services Manager and Center Director.</li><li>Will distribute work to the Social Work Assistant to support the social workers and Comfort Care end of life coordination</li><li>Partners with the Functional Manager of Social Work to implement best practice and standard processes</li><li>Ensures that staff is interpreting and adhering to agency and/or state policies, rules, and regulations by reviewing case records.</li><li>Monitors and evaluates the provision of client services in their assigned catchment provided to IGCP participants and their families.</li><li>Interviews participants when special problems arise, listens to concerns, grievances and recommends/takes appropriate action.  Escalates needs to the Social Services Manager and Center Director as appropriate</li><li>Travels by personal car to attend various meetings such as the Operations Council, Social Work Cross-Site, Center</li><li>Leadership and other committees and meetings requested by the Social Services Manager.</li></ul>Travel RequirementsTravel<ul><li>Travel may be required</li><li>Overnight travel may include local or out of state  </li></ul>Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.  REQUIRED<ul><li>Master’s degree from a school of social work accredited by the Council on Social Work Education</li><li>2+ yrs practicing social work with 1 yr in a healthcare setting</li><li>Experience providing case management, counseling and psychosocially related services to the elderly in addition to knowledge of mental health practices and techniques related to elderly care.</li><li>Requires valid state issued driver’s license, personal transportation, good driving record and auto insurance as required by law.</li><li>REQUIRED LICENSURE for NEW MEXICO</li><li>CPR/BLS and First Aid required in California only.</li></ul>Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW) from The New Mexico Board of Social Work-LMSW License PREFERRED<ul><li>5+ yrs in Social Services  </li><li>3+ yrs working with frail and elderly</li><li>2+ yrs supervising staff</li><li>Experience working in an IDT environment </li><li>Bi-lingual </li></ul>

Benefits:
InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model. InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. Applicants are considered until the position is filled.

Posted Pay Range:
$72,000-$90,000

Additional Information:
Compensation DisclaimerThe pay may vary depending on job related factors, such as work location, experience, knowledge, skills, education, certifications, training and internal equity.  InnovAge offers a comprehensive benefits package, which includes medical, dental, vision, 401(k) plan with company match, short and long-term disability, life insurance, supplemental life insurance, ADD, flexible spending account, paid time off and company paid holidays. Attention Florida Applicants This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse. For more information, please visit the Clearinghouse Education and Awareness website:  <a href="https://info.flclearinghouse.com" rel="noopener nofollow noreferrer" target="_blank">https://info.flclearinghouse.com</a> Agency DisclaimerInnovAge will not accept unsolicited resumes from search firms for this employment opportunity. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.

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Claims Advocate - Risk Services (Trucking/Transportation) Insurance Office of America

Social Services Supervisor InnovAge

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