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This is a full time, 40-hour per week, claim manager position in the Tumwater, Tacoma, or Spokane office. Manages caseload of approximately 140 workers’ compensation claims to ensure consistency with state WAC, RCW, and Labor and Industries policy. Provides service to clients which maximizes efficiency of their workers’ compensation program. Advises Washington State employers on workers’ compensation best practices. Engages and works as a team with both external and internal clients to achieve results. The focus of this job is on achieving results that are aligned with the larger picture of the organization and its strategic goals. Initiative, coupled with a sense of competitive drive, and the ability to stay focused on results despite changing conditions, is the key to achieving performance objectives of this job. The work involves innovation and creativity in generating ideas for quick response. Decision making is focused on implementing practical, timely solutions. The job requires getting things done quickly and handling a variety of activities. Self-assurance, and the confidence to purposefully drive toward results while constantly problem-solving and engaging the commitment of others is essential. The emphasis on building rapport and relationships with individuals and groups requires an outgoing, poised, and persuasive communication style. Because the pace of the work is faster than average, the ability to learn quickly and thoroughly while continually recognizing and adapting to changing conditions is critical. Emphasis is on results, and effective systems that achieve results through and with people, rather than on the details of implementation. The job environment is flexible, constantly changing and provides growth opportunity, recognition, and reward for the achievement of business results.
Responsibilities Include (but are not limited to):
- Review and analyze all documents pertaining to newly filed workers’ compensation claims including report of accident, chart notes, witness statements, work restrictions, etc.
- Initiate contact with employer clients to discuss new claims, expected duration, return to work, and strategic plan
- Help employer clients identify light duty work and put together job descriptions for appropriate work
- Aid employer clients with accident and validity investigation
- Conduct in-depth review and analysis including validity investigation, mechanism of injury, objective findings, wage calculations, return to work strategy, and development
- Educate regarding Retrospective Rating and impact on insurance rates and retro refund
- Create regular, detailed strategic plans identifying appropriate actions which drive claims to closure
- Teach employers and assist with making valid offers of employment
- Communicate with medical providers to obtain work restrictions and communicate work available with a variety of different employers
- Advise clients on best practices to maximize efficacy of their workers’ compensation programs
- Research and analyze complex medical materials including MD Guidelines and AMA Guides to make assessments of causation and treatment provided
- Prepare persuasive written and oral arguments to influence actions on a case
- Partner and strategize with other claims managers, attorneys, claims consultants, investigators, group managers, vocational consultants, HR professionals, and employer clients
- Prepare comprehensive claim staffing forms and orally present claim summaries and plans of action to bring claims to closure
- Triage claims and appropriate identifies priority issues
- Prefer at least five years of industrial insurance experience
- In-depth knowledge of and familiarity with Washington State Workers’ Compensation WAC and RCW
- Rapport and relationship building focused on achieving results
- Ability to engage commitment of others
- Sense of urgency for goal achievement
- Action-oriented and somewhat collaborative decision making
- Ability to make quick decisions in response to changing conditions
- Accountability for results Wages & Benefits:Wage depends on experience and is highly competitive for the industry. Medical, dental, and vision insurance. Short and long-term disability. Competitive vacation and paid time off policy. 401-k with matching.
- Additional benefits based on performance. ERNwest values work/life balance and is structured to reward high performers.