fremont,ca,94537
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1 week ago
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fremont, ca, 94537Job Description
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Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!
KEY OBJECTIVE:
This role focuses on the technical handling of workers' compensation claims. The individual will be accountable for overseeing teams responsible for the management and disposition of claims, including investigation, coverage determination, reserving, negotiation, settlement, and overall claims strategy. The position may require travel. You will represent the company in meetings with management, business partners, and other claims-related activities.
MAJOR DUTIES & RESPONSIBILITIES:
Claims Management Oversight:
* Oversee the daily operations of the workers' compensation claims process, ensuring compliance with regulations and company policies.
* Manage the end-to-end claims lifecycle, including assessment, investigation, coverage determination, reserving, negotiation, and settlement.
Team Leadership and Development:
* Supervise and develop claims teams, providing guidance, support, and training to enhance their skills and performance.
* Foster a collaborative and high-performing work environment that encourages professional growth and continuous improvement.
* Assist in recruiting and hiring claims representatives and team leaders, ensuring a strong team capable of meeting operational goals.
* Build and implement a succession plan to identify and prepare internal talent for leadership roles, promoting career advancement and staff retention.
Office Oversight:
* Ensure the physical office is well-organized and supports efficient workflow, including management of resources and equipment.
* Implement workplace policies that promote safety, compliance, and a positive culture.
Performance Monitoring and Reporting:
* Monitor team performance metrics and claims outcomes to identify trends, opportunities for improvement, and areas requiring additional training.
* Prepare and present regular reports on claims performance, cost management, and operational efficiency to management.
Client Relationship Management:
* Build and maintain strong relationships with clients, business partners, and external stakeholders to ensure satisfaction and foster trust.
* Collaborate with clients to identify opportunities to optimize their workers' compensation programs and reduce costs.
* Assist sales and marketing teams as new opportunities arise.
Strategic Planning and Implementation:
* Develop and implement strategic initiatives to improve claims processing efficiency and effectiveness.
* Stay current on industry best practices and regulatory changes to ensure the team's adherence to all pertinent laws and guidelines.
* Collaborate closely with the Claims Vice President to align departmental goals with broader organizational objectives, providing insights and recommendations for strategic decisions.
* Assist in the preparation of reports and presentations for the Claims Vice President, highlighting key performance indicators, operational challenges, and success stories.
* Support the Claims Vice President in implementing initiatives that enhance operational efficiency and drive continuous improvement within the claims department.
Dispute Resolution:
* Address escalated claims issues and disputes, employing negotiation and problem-solving skills to reach effective resolutions.
* Represent the organization in meetings, mediations, and hearings as necessary.
Training and Development:
* Develop and deliver training programs for claims staff to ensure comprehensive understanding of processes, policies, and regulatory requirements.
* Promote ongoing professional development and certification opportunities within the team.
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