Department:
Status:
Benefits Eligible:
Hours Per Week:
Schedule Details/Additional Information:
This is a full time position, 40 hrs, 1st shift.
Pay Range
$47.50 - $71.25Major Responsibilities:
- Must possess analytical skills and be able to work with a sense of urgency and accuracy. Must be able to adhere to multiple state workers’ compensation rules, regulations, and laws.
- Establish standards and procedures for all matters relating to the claims functions.
- Develop, maintain, and modify, when needed, effective procedures to ensure timely claims resolution maintaining a specialized base of knowledge regarding claims negotiation and settlement techniques.
- Must function as a resource to the injured teammates, leaders, and others with an interest in the claim.
- Acts as a resource to the Workers Compensation team on audit work, processes and other complex issues.
- Recommend reserves, settlements, or other actions. Ensuring that these actions meet company standards and the liability, damages, coverages, etc. have been rigorously evaluated. Provide proper and timely analysis of coverage including MMSEA (Medicare, Medicaid and SCHIP Extension Act) Reporting.
- Must be able to communicate with the injured teammate and other parties, as necessary.
- Monitor reserves and settlements associated with claims and provide appropriate reports as needed to leadership.
- Maintain claims data in such a manner that monthly reports for loss forecasting and trend analysis may be conducted.
- Assist leadership in evaluating excess policies to ensure the most favorable terms and conditions for the organization.
- Assist in the development, recommendation and/or implementation of loss prevention activities.
- Participate as needed in educational programs such as orientations to ensure awareness of the procedures associated with claims documentation and settlement.
- Must be able to provide additional support for all other duties as assigned.
Licensure, Registration, and/or Certification Required:
- Adjusters license required for area of responsibility as required by specific jurisdiction as applicable.
Education Required:
- Bachelor's degree in related field.
Experience Required:
- Typically requires 5 years of experience with Workers Compensation claims administration.
Knowledge, Skills & Abilities Required:
- 10+ years of experience with Worker's Compensation claims administration will be considered in lieu of possessing a bachelor's degree.
- Excellent Oral and written communication skills, organizational skills, attention to detail, computer skills, and ability to manage multiple tasks required.
- Demonstrated proficiency in working with Microsoft Excel, Access, and PowerPoint required.
- Experience with RMIS Systems preferred.
- Will limit access to protected health information (PHI) to the information necessary to do the job.
- Will share information only on a need-to-know basis for work purposes.
Physical Requirements and Working Conditions:
- This position requires travel, therefore, will be exposed to weather and road conditions.
- Operates all equipment necessary to perform the job.
- Exposed to a normal office environment.
- Requires the ability to work rapidly and accurately under pressure and to manage many different issues and priorities simultaneously.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Due to complex requirements, remote work is NOT permitted for short or long periods in: CA, DC, CO, CT, HI, MA, MD, MN, NJ, NY, OR, RI, VT, WA and working Internationally (this includes working while on vacation). #LI-Remote #Remote
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Top Skills
What We Do
Advocate Aurora Health is the 11th largest not-for-profit, integrated health system in the United States. As a leading employer in the Midwest, Advocate Aurora Health employs more than 75,000 individuals including more than 22,000 nurses. Advocate Aurora is engaged in hundreds of clinical trials and research studies, and is nationally recognized for its expertise in cardiology, neurosciences, oncology and pediatrics. The organization contributed nearly $2.2 billion in charitable care and services to its communities in 2019.
