Risk Management Claims Coordindator

Del Taco; Lake Forest (CA); On-site; USD 60,000 - 85,000; Full time

Job summary

Del Taco is seeking a Risk Management Claims Coordinator in Lake Forest, CA to assist in the administration, investigation, interpretation and reporting of employee, guest and store incidents including injuries, illnesses and theft for the enterprise.

The role involves coordinating with the Third-Party Administrator, insurers and healthcare providers, preparing regular workers’ compensation cost analyses, and returning injured employees to work while maintaining thorough departmental records.

Qualifications

• Must have at least 2 years of claims administration experience.
• High School diploma required; Bachelor's degree preferred.
• Bilingual English/Spanish communication skills preferred.
• Proficiency with Microsoft Office including Word and Excel.
• Experience with Origami is a plus.

Responsibilities

• Assist investigations for employee and customer incidents.
• Compile and interpret data on work-related injuries and illnesses.
• Prepare monthly, quarterly, and annual reports on Workers’ Compensation costs.
• Maintain, coordinate, and administer claims with insurers and parties.
• Identify trends in workers’ compensation costs.
• Coordinate return-to-work processes with healthcare providers.
• Prepare documentation for pre-litigation of customer complaints.
• Support surveillance and wage statement request processes.
• Interact with law enforcement and third-party administrators as needed.
• Other duties as assigned.

Skills

Claims administration

Investigations

Data reporting

Analytical skills

Communication skills

Bilingual English/Spanish

Education

High School diploma required

Bachelor's degree preferred

Microsoft Office proficiency

Tools

Microsoft Word

Microsoft Excel

Origami

Job description

Job Title

Risk Management Claims Coordinator

Classification

Full Time, Non-Exempt

Department

Risk Management

Job Summary

Responsible for assisting the administration, investigation, interpretation and reporting of employee, Guest and store incidents including injuries, illnesses and theft for the enterprise.

Essential Duties and Responsibilities

• Assists with investigations for both employee and customer incidents
• Compiles, reports and interprets data pertaining to work-related employee injuries and illnesses
• Compiles and reports data pertaining to Workers’ Compensation claims cost.
• Prepares monthly, quarterly, and annual reports containing analyses and graphic illustrations of Worker’s Compensation claims costs
• Interprets data and identifies trends pertaining to Worker’s Compensation claims costs to include cost of accident, damages, and claim loss
• Investigate reports of work-related employee injuries and illnesses
• Maintains, coordinates, manages, monitors and administers claims including claim form preparation, claim submittal, contact with insurance representatives, clients, liability carriers, contractors, employees, etc.
• Maintains, manages, and updates departmental files
• Prepares management reports on employee injuries, customer as well as robbery/theft/burglary incidents
• Prepares documentation, investigates and assists insurance company in pre-litigation of customer complaints
• Prepare monthly, quarterly, and annual reports containing analyses and graphic illustrations of Worker’s Compensation claims costs.
• Compiles and reports data pertaining to Work-Related employee injuries and illnesses, Workers Compensation costs, and administers the Return-to-Work Program
• Serve as a representative for the company while interacting and maintaining constant communication with the law enforcement community and agencies in matters pertaining to internal and external theft and fraud
• Works closely with our Third-Party Administrator (TPA) and Workers’ Compensation Adjusters on work-related injuries and treatment plans, coordinate treatment with pre-selected health care providers
• Works directly with injured employees ensuring goodwill and exploring return-to-work opportunities
• Work involves reviewing, evaluating, inspecting, and developing a facility program in liability, and/or risk exposure related to facility workforce
• Manage surveillance video requests
• Manage wage statement requests
• Compile documents for subpoenas
• Monitor Safety Inspections for completeness and accuracy
• Other duties as assigned

QUALIFICATIONS

An individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EDUCATION and/or EXPERIENCE

• Must have at least 2 years of previous claims administration experience.
• High School diploma required; Bachelors Degree preferred.
• Experience in successfully working in multiple organizational structures and matrix environment.
• Bilingual English/Spanish communication skills preferred.
• Knowledge of Windows system including Microsoft Office, Word, and Excel.
• Experience with Origami preferred.

SKILLS

• Ability to express ideas persuasively and clearly.
• Ability to read, analyze, and interpret legal documents and claims information.
• Ability to respond to common inquiries from employees and management team.
• Sound research and investigative skills.
• Ability to work under limited supervision
• Must be able to communicate effectively, verbally and in writing, with key stakeholders and outside contacts such as physicians, insurance companies, network providers, attorneys, third party administrators, vendors and outside consultants.
• Excellent verbal and written communication skills.
• Bilingual preferred.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

While performing the duties of this job, the employee is regularly required to sit, talk, or hear. The employee frequently is required to use hands to handle or feel, and also to reach with hands and arms. The employee is occasionally required to stand and walk.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Temperature controlled office.
• The noise level in the work environment is low to moderate.

EQUIPMENT USED

Computer, copier, printer, scanner, phone