Workers’ Compensation Representative

($48,401 - $65,353 annually)

We are seeking a Workers’ Compensation Representative we can rely on to be responsible for all administrative functions required by the City of Mesa and state statute that involves the self-administration of a Workers’ Compensation self-insurance program. The position's functions and responsibilities include but are not limited to: 

Partnering with team members in adjudicating workers’ compensation claims Assigning rehabilitation nurses, private investigators, vocational specialists Filing notices with the Industrial Commission of Arizona (ICA)Authorizing medical treatment, calculating workers’ compensation awards, paying medical bills, processing indemnity payments and reporting expenditures through reports to administration and excess workers’ compensation provider Approving or denying a workers’ compensation claim or medical treatment, within guidelines established by the ICA and City of Mesa Act as the Human Resources representative assisting injured workers and physicians by filing and expediting claims, explaining Worker's Compensation regulations, and resolving a variety of problems Work independently in the management and direction of the most complex Worker's Compensation claims and makes difficult decisions concerning medical and Worker's Compensation benefits 

This position is supervised by the Safety Administrator through meetings, reports, conferences, and overall results achieved. This class is FLSA nonexempt.

Requirements:

Minimum Qualification(s) Required

Any combination of training, education, and experience equivalent to graduation from high school or GED Considerable (3 - 5 years) experience in workers’ compensation claims processing/adjudication as a workers’ compensation representative/adjuster Good (1 - 3 years) experience working with Arizona Workers’ Compensation statutes and state and federal regulations pertaining to Workers’ Compensation claims handling 

City of Mesa offers a competitive benefits package. A CITY OF MESA ONLINE APPLICATION IS REQUIRED.  Applications will be available as of the opening date of 02/10/12. Apply by 02/23/12. For complete job description, requirements and online application form, please visit our web site at: www.mesaaz.gov/jobs.  

The City of Mesa respects, values and welcomes diversity in our workforce. To this end, we encourage all interested people to apply. EOE/AAE

 

 

TITLE: Multi-Lines Claims Supervisor

SUMMARY:

We are currently looking for an experienced Multi-Line Claims Supervisor.  This position involves supervision of approximately 15 core workers’ compensation, property and casualty claims adjusters.  The person in this position will work closely with, and at the direction of, the claims manager in supervising claims staff, auditing adjuster outcomes and compliance, and assisting with a variety of projects and programs.  

The position requires a minimum of 10 years’ multi-lines claims experience and strong supervisory skills. 

ESSENTIAL FUNCTIONS/RESPONSIBILITIES:

Assist the claims manager in ensuring that the Claims Department achieves optimum accuracy, efficiency, and productivity in claims administration and adjudication.  Provide feedback to the claims manager on all claims staff performance—including compliance with best practices and regulatory and statutory requirements—for annual performance reviews.  Manage vendors on a day-to-day basis, including determination of fees and monitoring of service quality.   Conduct regular audits of adjuster claim administration outcomes; prepare audit and analytical reports related to claim adjuster statistics and outcomes. Review claim files for required documentation (releases, W-9s, etc.) and verify that invoices have been properly audited before claim payments are presented to the claims manager for issuance of checks.     Provide backup, as-needed, in preparation of management reports and in reporting to clients on claim issues.  Assist with implementation of new programs with external vendors, and in development of in-house programs geared toward enhanced savings and quality of services.  Assist with software conversions and the implementation of new or enhanced technical configurations.  Assist the claims manager with implementation and enforcement of departmental operational standards (benchmarks), procedures, and policies to achieve and increase target production goals; recommend initiatives and programs to optimize and improve the department’s profitability; and advise the claims manager on possible performance enhancing technology and procedures.  Assist with development, coordination, and implementation of strategic goals related to claims.  Assist with training and development of staff.  Settle high-exposure claims. 

SKILLS/REQUIREMENTS:

·         Multi-lines claims experience (minimum 10 years desired), including general liability, auto liability, property, and Arizona workers’ compensation

·         Arizona adjuster’s license

·         Bachelor’s degree or equivalent experience

·         Proficiency in Microsoft Office, especially Excel

·         Supervisory and problem-solving skills

·         Knowledge of claims handling and related procedures, Arizona regulations, and claims litigation strategies; ability to advise outside legal counsel accordingly

·         Ability to write correspondence and assist with development of procedures, policies, and supporting documentation

·         Ability to establish and maintain constructive supervisory relationships with diverse group of employees 

·         Strong organization and coordination skills, and ability to handle multiple priorities

PAY COMMENTS

We offer a competitive compensation and benefit package that includes: medical, dental, life insurance, disability, paid holidays, paid time off, and 401(k). Ashton Tiffany pays 100% of employee benefit premiums. Apply now!

IMPORTANT NOTES

To apply for this position, please click on the link below:

http://tbe.taleo.net/NA4/ats/careers/requisition.jsp?org=ASHTONTIFFANY&cws=1&rid=54

 

Banner Health

Job Title: Workers Comp Adjuster

Overview:

Banner Health is the state’s second largest private employer, and one of Northern Colorado's largest employers. We are the leading nonprofit employer in every community we serve. At Banner Health, we believe fully engaged employees are the  foundation of providing excellent patient care. We value diversity and offer excellent career opportunities with great benefits for those looking to make a difference in the communities we serve. 

The Workers Compensation Adjuster will be located at our Mesa Corporate facility at 525 West Brown Rd. (Country Club and Brown).

Responsibilities:

POSITION SUMMARY

This position is responsible for administering claims and controlling medical costs, liability, and conducting various investigations into claims that result from work related injuries or illnesses.

ESSENTIAL FUNCTIONS

1. Evaluates work injury claims and medical reports to determine appropriateness of treatments and disability benefits. Refers cases to medical management as appropriate, adjusts charges as needed and authorizes payment of benefits and billings for other approved services.

2. Provides customer service and information to claimants. Communicates coverage, benefits, and legal responsibilities to the injured employee, supervisor, attorneys, physicians and other medical providers.

3. Determines what appropriate legal notices and correspondence are to be issued as required by the Industrial Commission of Arizona. Determines if the claim is reportable under the guidelines of the Occupational Safety and Health Act (OSHA) and assigns an OSHA status to the claim as required.

4. Conducts direct investigations which include background checks, written and recorded statements of claimants and witnesses, interview managers, safety experts, physicians, police and or obtaining police records and other documents or court records as the case develops.

5. Directs and monitors outside investigations which may include; video surveillance and background checks, photography of accident scenes or equipment or accident re-constructionists and witness statements.

6. Coordinates with the Independent Medical Evaluation team to authorize medical treatments, evaluates progress of claim and coordinates consultations and referrals. Composes correspondence and reports to attending or independent evaluating physicians summarizing treatment and prognosis requesting opinions of current findings.

7. Establishes financial reserve levels and monitors changes in the reserve for future expected or unexpected liability.

8. Negotiates compromise and settlement agreements, which consists of monetary and other coverage considerations, and/or prepares cases to go to hearings or trials.

Qualifications:

Requires an Associates degree in a related field or equivalent knowledge and experience.

Must possess current knowledge of workers' compensation rules, regulations, procedures and protocols. Requires the ability to use effective verbal and written communication skills, while dealing with a variety of difficult and complex human relation situations. Must be able to organize and prioritize daily work loads to meet deadlines and work under pressure. Must have intermediate level of medical terminology and basic anatomy. License or certification may be required for some work assignments.

Requires the ability to work effectively with all common office software.

PREFERRED QUALIFICATIONS

Prefer workers compensations license, or Average Weighted Cost of Capital (AWCC), Associate in Risk Management (ARM) certification or related in the field.

 

 

Pinnacle Risk Management

We are looking for: Receptionist

Senior Claims Adjuster with five to ten years of experience

Please Contact:

Pinnacle Risk Management Services

7500 North Dreamy Draw Drive

Suite 135

Phoenix, AZ 85020

Attn: Karen Kownacki

(480) 367-2017

kkownack@pinnaclerisk.com

 

 

City of Scottsdale

Now accepting applications for the following position(s):

Safety Coordinator

To view the full job posting for any opening at City of Scottsdale, click here:

http://agency.governmentjobs.com/scottsdaleaz/default.cfm  Click on a job title to view the complete job posting of any position listed. After you have reviewed the job posting, you can apply for the position by clicking on the "Apply" button and completing the online application. Job interest cards are active for one year from the date of submission. Until that date, you will be notified when any position for the job category or job classifications that you have selected becomes available. We'll also send you a reminder email one month before your interest card is due to expire to give you an opportunity at that time to extend your notifications for another year. If at any time you wish to cancel notifications for this interest card, please visit the following web address  https://www.governmentjobs.com/myinterestcards.cfm?OJRID=1998586&EMA=etaylor@scottsdaleaz.gov Thank you and good luck in your job search!

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