Self-Insured Claims Manager

Minutemen HR; Cleveland (OH); On-site; USD 52,000 - 76,000; Full time

Job summary

Minutemen HR is seeking an experienced claims professional to manage day-to-day claims, assess injuries, and coordinate settlements. You will handle handicap reimbursement, lump sum negotiations, hearings, and return-to-work information, while maintaining detailed records and client communication.

The role requires independent judgment, ability to set reserves, review letters, and work with risk management leadership to optimize outcomes for clients and carriers.

Responsibilities

• Independent discretion and control over day to day claims management.
• Identify, filing and attendance at hearings for handicap reimbursement.
• Lump Sum Settlements - Identify, negotiation, customer contact and filing.
• Review of new injuries: certification/rejection, return to work information.
• RTW practices - Knowledge of and recommendations to the employer.
• Client Contact - In person and by phone for current customers. Also to work with Client Relations Managers for prospective customers as needed.
• Employer Education - Knowledge of and recommendations to employer regarding cost containment strategies.
• IME/IMR determination, report review and submission.
• Review of all BWC/IC letters, notices and orders and respond to all requests as necessary.
• Make appropriate recommendations to clientele regarding appeals and responses.
• Complete analysis of new client's losses and attend initial "meet and greet" as determined by assigned CRM to discuss claim strategies/plan of action.
• Review and preparation of hearing files.
• Attendance for ongoing updates/training internally/externally as deemed necessary by VP of Risk Management.
• Calculation/entering of compensation payments.
• Training and oversight of new and/or current employees as necessary.
• Coordination of MSA's for all potential settlements.
• Identification, notification and collection of subrogation liens.
• Identification, notification and reimbursement requests to excess carriers.
• Handling of all phone calls regarding inquiries of bill payments/status.
• Bill determination.
• Setting and maintaining reserves based on probable outcome with detailed rationale.
• Other responsibilities as assigned.

Job description

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Independent discretion and control over day to day claims management.
• Handicap Reimbursement - Identify, filing and attendance at hearings.
• Lump Sum Settlements - Identify, negotiation, customer contact and filing.
• Review of new injuries: certification/rejection, return to work information.
• RTW practices - Knowledge of and recommendations to the employer.
• Client Contact - In person and by phone for current customers. Also to work with Client Relations Managers for prospective customers as needed.
• Employer Education - Knowledge of and recommendations to employer regarding cost containment strategies.
• IME/IMR determination, report review and submission.
• Review of all BWC/IC letters, notices and orders and respond to all requests as necessary.
• Make appropriate recommendations to clientele regarding appeals and responses.
• Complete analysis of new client's losses and attend initial "meet and greet" as determined by assigned CRM to discuss claim strategies/plan of action.
• Review and preparation of hearing files.
• Attendance for ongoing updates/training internally/externally as deemed necessary by VP of Risk Management.
• Calculation/entering of compensation payments.
• Training and oversight of new and/or current employees as necessary.
• Coordination of MSA's for all potential settlements.
• Identification, notification and collection of subrogation liens.
• Identification, notification and reimbursement requests to excess carriers.
• Handling of all phone calls regarding inquiries of bill payments/status.
• Bill determination.
• Setting and maintaining reserves based on probable outcome with detailed rationale.
• Other responsibilities as assigned.