This job ad has been posted over 60 days ago...
0
applicants
Workers' Compensation Claims Supervisor - Veolia - Irving, TX
at Sedgwick Claims Management in Texas
Workers' CompensationClaims Supervisor I - Veolia
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006 and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To oversee medical care, return to work processes and clinical consultation intervention for Veolia; to facilitate channeling of preferred and best in class medical treatment; to facilitate reporting of claims; to communicate with client and coach/mentor client and colleagues to provide training to client and colleagues; to monitor workload; and to provide leadership and technical support to colleagues on claims adjudication and medical management activities.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Oversees strategic assignment of claims.
Identifies and advises management of trends and problems/issues and recommends course of action; informs management of new procedures and ideas for continuous process improvement; and works with management to coordinate projects for specified office.
Provides technical/jurisdictional support to colleagues on claims adjudication; acts as second level of appeal for client and employees' issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
Compiles, reviews and analyzes performance management reports to focus on client goals; performs quality review on disability claims in compliance with audit requirements, service contract requirements and quality standards.
Reviews Plan of Action documents communicating reserve developments on high exposure claims and claims over the authority of the examiner; monitors sensitive and questionable claims as determined by client.
Maintains personal contact with colleagues and promotes a professional leadership/mentoring relationship; makes recommendations to colleagues as suggested by the claim status.
Ensures claim files are coded correctly and have adequate documentation.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
SUPERVISORY RESPONSIBILITIES
Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
Provides support, guidance, leadership and motivation to promote maximum performance.
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
Experience
Six(6) years claims management experience required.
Skills & Knowledge
Good technical knowledge of claims management
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
Jurisdictional Experience Preferred: Multiple States
License or Certification(s) Required: Texas
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/15413393
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006 and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To oversee medical care, return to work processes and clinical consultation intervention for Veolia; to facilitate channeling of preferred and best in class medical treatment; to facilitate reporting of claims; to communicate with client and coach/mentor client and colleagues to provide training to client and colleagues; to monitor workload; and to provide leadership and technical support to colleagues on claims adjudication and medical management activities.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Oversees strategic assignment of claims.
Identifies and advises management of trends and problems/issues and recommends course of action; informs management of new procedures and ideas for continuous process improvement; and works with management to coordinate projects for specified office.
Provides technical/jurisdictional support to colleagues on claims adjudication; acts as second level of appeal for client and employees' issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
Compiles, reviews and analyzes performance management reports to focus on client goals; performs quality review on disability claims in compliance with audit requirements, service contract requirements and quality standards.
Reviews Plan of Action documents communicating reserve developments on high exposure claims and claims over the authority of the examiner; monitors sensitive and questionable claims as determined by client.
Maintains personal contact with colleagues and promotes a professional leadership/mentoring relationship; makes recommendations to colleagues as suggested by the claim status.
Ensures claim files are coded correctly and have adequate documentation.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
SUPERVISORY RESPONSIBILITIES
Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
Provides support, guidance, leadership and motivation to promote maximum performance.
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
Experience
Six(6) years claims management experience required.
Skills & Knowledge
Good technical knowledge of claims management
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
Jurisdictional Experience Preferred: Multiple States
License or Certification(s) Required: Texas
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/15413393
Recent jobs at Sedgwick Claims Management
FMLA Specialist I at Sedgwick Claims Management in California
Nov 24, 2010
Benefits Liaison at Sedgwick Claims Management in California
Jul 13, 2010
FMLA Specialist II at Sedgwick Claims Management in Texas
May 12, 2010
Published on Mar 10, 2010
Viewed: 202 times
Viewed: 202 times
Search Insurance Jobs by State: