Recognized on the Inc. 5000 Honor Roll of fastest growing companies in the nation - Engage PEO is a leading, national Professional Employer Organization (PEO) - and we continue to grow! We are seeking a Workers’ Compensation Claims Associate to join our dynamic team. This position will be a part of the Workers’ Compensation Claims team and will be responsible for claims investigation, claim reporting, and timely, effective claim management of workers compensation medical only claims. The Workers’ Compensation Claims Associate will report directly to the Amy MacDonald Manager. This position works collaboratively with our Clients, insurance carriers, and loss control personnel to effectively reduce and mitigate our workers compensation exposures. This position also works collaboratively with our underwriters, and other internal departments to coordinate and deliver Engage’s products and services to our Clients. This employee must be willing to work central or pacific hours.
- Promptly investigate new employee injuries by contacting our client employer, the injured worker, his/her supervisor, or witnesses and reviewing all evidence received related to the work incident
- Check policy coverage to ensure new claims received are covered, set up to the correct location and reported to the appropriate insurance carrier
- Determine whether there is any possible subrogation potential on a new claim
- Ensure the injured worker has been offered and/or received initial medical treatment if needed
- Coordinate light duty availability with our client employer so that the injured worker can return to work within the waiting period when possible
- Maintain communication with the insurance adjuster, Client and injured worker, and any other persons involved throughout the claim so that everyone is aware of current updates
- Monitor medical treatment and ensure the injured worker is attending scheduled appointments and continues to work
- Maintain an organized file, documented with clear and concise notes of activities, medical treatment, return to work status and action plan to allow for easy review of the file by co-workers or managers
- Maintain and document an accurate return to work history on each claim for OSHA log reporting and compliance
- Maintain a diary with tasks assigned for each claim so that all claim files are monitored, reviewed, and closed on a timely basis
- Determine when vendor involvement may be necessary, such as medical case management, vocational rehabilitation counseling, legal, surveillance, Independent Medical Examiner (IME), Independent Adjuster (IA), etc., and discuss with Claims Manager
- Ability to oversee Insurance Carrier or Third-Party Administrator (TPA) staff to ensure best practices and contractual compliance. Ensure our partners control the cost of claims through effective diary management and oversight of claim files
- Provide exceptional client service to internal and external Clients
- Ability to work independently and multi-task
- Strong analytical and problem-solving skills and sound judgment
- Must possess superb Microsoft Office Applications skills
- Excellent written & verbal communication skills
- Exceptional client service skills
- Excellent problem-solving, interpersonal, and organizational skills
- Demonstrate an open-minded, team-oriented, and collaborative work style
- Ability to work in dynamic, rapidly changing environment, adapting to changing requirements and collaborating with a wide range of colleagues to quickly deliver solutions
- Extremely detail-oriented with demonstrated ability to self-direct, prioritize work, and meet deadlines
EDUCATION AND EXPERIENCE
- Bachelor's degree in Risk Management, Insurance or related field, or equivalent combination of experience and education
- Minimum of 1+ years’ claims experience or employer risk management experience.
- Prior PEO experience is preferred but not required
- ClientSpace and PrismHR knowledge is a plus
We offer a competitive salary and comprehensive benefits package.
Please send your resume and salary requirements to: email@example.com
Engage PEO provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.