Workers Compensation Claims Supervisor JD Advantage

The NJM Workers Compensation team is searching for a Regional Claims Supervisor. The Regional Claims Supervisor will utilize their knowledge of Workers’ Compensation Claims to analyze litigated claims to achieve appropriate outcome in accordance with legal statues, policy provisions, and company guidelines. This position will assist with supervising claims staff and provide support to ensure achievement of appropriate claim outcomes through consistent execution of best claims practices.

Schedule:

Monday-Friday, specific hours are subject to selected start times between 8:00am-9:00am pending supervisory approval.

This role is based in the NJM Hammonton office, and occasional travel to other NJM locations is expected to support collaboration and business objectives.

Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job.

• Develop, recommend, and implement departmental objectives consistent with company business goals, guidelines, and programs

• Assist with developing and executing strategic and operational goals and objectives for the WCC department

• Recommend process improvement where applicable to best improve the department and staff’s efficiency, work product, and service commitment to interested parties

• Utilize quality assurance and KPI reports to effectively maximize performance, identify, and correct performance issues, and provide staff development opportunities

• Lead team meetings and facilitate training, inclusive of one-one staff meetings to ensure and coach to staff success and promote effective communication with employees

• Direct claims staff through technical aspects and supporting proactive execution of action plans to resolve claim issues and concerns to move cases toward closure

• Recognize and investigate subrogation opportunity for recovery of third party funds and direct staff to pursue further information

• Ensure quality management of claims in accordance with claims best practices and company guidelines, and timely, accurate documentation of claim activity

• Collaborate with internal resources such as NJM legal staff, SIU, and Medical Services to successfully resolve and/or settle cases in a timely fashion

• Provide technical direction and ongoing guidance through effective diary management

• Negotiate settlements within granted authority, with periodic attendance at claim mediations and settlement conference to effectively resolve cases

• Ensure appropriate case reserves for 90 Day and Credit Reviews consistent with company guidelines

• Assist staff with preparation, attendance, and conducting Claim Reviews

• Partner with Claim Account teams to manage large account (assignments) and develop rapport, trust, and manage expectations of servicing requirements

• Maintain a working knowledge of jurisdictional requirements, forms and applicable case law for each state serviced

• Participate in outside defense counsel evaluation process and firm selection

• Apply critical thinking skills and multiple perspectives to different situations and strategically consider a systematic way to mitigate exposures by collaborating with staff and establishing a plan of action

• Demonstrate a commitment to NJM’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work

Required Qualifications: Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license requirements.

• HS Diploma or GED Equivalent

• 5 to 8 years claims handling experience with a sound knowledge of WC regulations and case law

• Sound litigation management skills and demonstrated ability to evaluate, negotiate, and settle litigated claims, inclusive of or developing knowledge of alternative settlement techniques such as CP liens, medical liens, medical set-asides, and annuity options

• Excellent ability to assist, support, and strategically manage complex legal cases

• Customer service oriented with excellent written and oral communication skills

• Demonstrated leadership, coaching, mentoring, and teamwork skills

• Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details

• Experience utilizing an automated claim processing system and the Microsoft Office suite of tools (Word, Excel, PowerPoint)

• Strong organizational skills with demonstrated ability to work independently and prioritize responsibilities

• Ability to travel occasionally for business purposes

• Multi-state experience and/or licensing (including MD, CT, DE, PA and/or NY)

Preferred Qualifications:

• Bachelor's degree and/or five to eight years of equivalent work experience preferred in an insurance related industry require

• Previous experience in a leadership position with proven record of successful team building, goal achievement, and superior customer service

• Professional designations (CPCU, ARM, AIC, etc.)

Compensation: Salary is commensurate with experience and credentials.

Pay Range: $88,176-$111,218

Tagged as: $75k to $150k