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    Sr. Claims Specialist - Tampa, United States - Advanced Dynamics Corp

    Advanced Dynamics Corp
    Advanced Dynamics Corp Tampa, United States

    5 days ago

    Default job background
    Description

    This is a remote position.

    Job Title: Sr. Specialist, Claims

    Classification: Salaried, Exempt (FTE)

    Reports To: Director of Risk Management

    Last Modified: 04/29/2024

    Our client serves as a dedicated strategic partner to government and other clients. We seek to hire people who share our dedication to excellence, our passion for the work, and our commitment to a collaborative and inclusive work environment.

    Summary:

    The Sr. Specialist, Claims is responsible for managing workers' compensation claims activity from conception to resolution.

    Essential Functions:

    · Manage Workers' Compensation claims activity from conception to resolution, performing technical analysis and take proactive steps to mitigate claim cost.

    · Maintain strong relationships with internal and external business partners.

    · Review, approve or provide oversight of medical and miscellaneous invoices to determine if reasonable and related to designated claims.

    · Negotiate with medical providers and third parties on self-insurance settlements.

    · Coordinates and participates in strategic planning aimed at identifying developing trends with respect to type of loss, severity, and frequency.

    · Communicates and interacts with medical professionals, carriers, operations, and HR partners to monitor and assess the progress of rehabilitation efforts, and to facilitate return to work.

    · Lead and mentor peers on various claims processes/tasks.

    · Work together with the Director of Corporate Insurance and Risk on other departmental and administrative duties as assigned.

    · Other duties as assigned.

    Knowledge and Skills:

    · Proficient with Microsoft Office Suite.

    · Thorough knowledge of the Workers' Compensation coverage and process.

    · Taking the initiative and being resourceful.

    · Ability to use independent judgment and make appropriate insurance claims adjustment decisions and determinations.

    · Excellent interpersonal communication skills.

    · Conflict resolution and/or mediation skills.

    · Ability to maintain confidentiality in matters involving personnel issues.

    · Analytical and problem-solving skills.

    · Attention to detail and ability to produce both standard and ad hoc reports.

    · Adaptable to new concerns and changing environments.

    · Ability to work flexible hours. We operate 24/7/365.

    Education and Experience:

    · Bachelor's degree in business administration, risk management, or a related field.

    · 5+ years of experience handling workers compensation claims

    · Workers' Compensation Multi-jurisdiction, self-insured company and/or TPA and AIC or similar designation preferred.

    · Proven experience working in full collaboration across multiple disciplines, both internal and external.

    · Bilingual (English/Spanish) preferred.

    · Must be authorized to work in the U.S. and able to travel within the Continental United States (CONUS).

    · Must pass a background check after accepting a conditional offer of employment.

    Supervisory Responsibility

    This position will not have direct reports.

    Work Environment- This position operates in a remote environment, seven days a week and holidays.

    Travel - 10%



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