Manager, Claims Administration

About the role

Reporting to the Head of Total Rewards, Human Resources, the Manager of Claims Administration is responsible for management of all day-to-day transactional activities related to medical claims, including direct management of claims administrative staff and assessment to determine best solutions for effective claims management.

Responsibilities

• Medical oversight of day-to-day claims handling activities involved with FMLA, ADA, STD, LTD, WC and Modified Duty Restrictions.
• Directly manage the Claims Examiner staff.
• Collaborate with outside Third Party Claim Administrators and internal Claims Staff to assure timely leave coordination and return to work planning.
• Field inquiries from outside Claim Administrators and triage requests according to WC Charter and TPA Customer Service Instructions.
• Coordinate WC meetings and present cases to corporate Workers’ Compensation Settlement Committee.
• Oversee Claims Examiner management of Workers’ Compensation & Disability intranet sites.
• Ensure compliance with annual WC posters and panel card renewals.
• Coordinate WC job offer letters according to jurisdictional statutes.
• Oversight of WC document handling: subpoenas, wage requests, settlements/SAGR to Compliance.
• Work with all members of the Absence Management Department to coordinate alternative medical leave options when Workers’ Compensation claims are denied.
• Management of policies and procedures to ensure efficient delivery of services to employees.
• Work with business units to implement effective controls.
• Work with department leader and other departments to identify potential streamlining through process integration.
• Provide newly acquired companies with claims processes. Assist them with integration process as well as pre and post acquisition claim issues.
• Implement Leader’s system changes that will motivate positive claims performance in business units.
• Coordinate with the Prevention of Critical Injury (PCI) team to resolve cases.
• Complete special projects as assigned.
• Travel, as required, approximately 5%.

Qualifications

• 8-10 years of disability management experience.
• 4-year college degree.
• Experience with insourced and outsourced program models.
• 5+ recent years managing a team.
• Workers’ Compensation experience.
• Case management experience.
• Workday experience.

Skills

• Benefit administration or similar administrative skills.
• Excellent computer applications and problem-solving ability.
• Negotiation skills.
• Complete understanding of all current plans and practices including subsidiary plans and practices.
• Ability to be completely objective and not easily swayed by the personal interest of unit administrators or individual employee claimants.
• Excellent written and verbal communication skills for both counseling and meeting presentations.
• Excellent interpersonal skills and the ability to deal with all levels of management and employees on very sensitive and emotional issues.
• Strong working knowledge of Microsoft Windows software applications.

Desirable, not essential: Workers’ Compensation certification, Case Management certification, previous business experience.

Benefits

• Opportunity to grow and develop your career.
• Inclusive environment that encourages diverse perspectives and ideas.
• Challenging and unique opportunities to contribute to the success of a transforming organization.
• Comprehensive benefits globally (PB Benefits and Wellbeing Programs).