Address
Form of workThe Claims Coordinator is responsible for efficiently managing and processing workers’ compensation, auto and property insurance claims. It involves investigating incidents and gathering data, evaluating claims, communicating with stakeholders and insurance examiners, and ensuring legal compliance. This position is also responsible for fulfillment of requests for Certificates of Insurance (“COIs”), the management of same, as well as the management of third-party COIs and OCIP enrollment. You will contribute to maintaining a safe work environment while safeguarding the interests of the company and its employees.
Essential Duties:
- Oversee and navigate the complete lifecycle of workers’ compensation claims, guaranteeing precise and punctual resolution. This includes maintaining incident and claim information in the risk management information system.
- Evaluate and assess workers’ compensation claims submitted by injured employees.
- Determine the validity of claims by investigating the circumstances of the injuries and reviewing relevant documentation.
- Collaborate with medical professionals, legal teams, and other stakeholders to assess the extent of injuries and determine appropriate compensation.
- Investigate, address, and resolve any disparities or inconsistencies in the handling of claims.
- Communicate with injured employees and their supervisors, medical providers, legal representatives, claims adjusters, and other relevant parties to gather information and provide updates on claims.
- Provide clear and accurate information to employees concerning their benefits, rights, and responsibilities throughout the claims process.
- Manage claims encompassing multiple states, guaranteeing adherence to distinct state regulations and insurance claim laws.
- Stay updated on workers' compensation laws, regulations, and guidelines in each state where the company operates.
- Understand the differences in requirements, benefits, and processes among different states to ensure compliance and accuracy.
- Partner with third-party administrators, medical providers, legal representatives, and other service providers to streamline the claims processing procedure.
- Conduct negotiations with injured employees, legal representatives, and insurance providers to achieve fitting compensation settlements.
- Verify that settlements align with legal mandates and company protocols.
- Record all claim-related information meticulously in risk management information system.
- Adhere to strict confidentiality and ethical standards when handling sensitive claim information.
- Analyze claims data to detect patterns and possibilities for enhancing the claims management procedure.
- Implement process improvements to enhance efficiency, accuracy, and overall claims management effectiveness.
- Manage the complete lifecycle of first-party and third-party auto and property insurance claims, which includes communicating with internal stakeholders, claims examiners and third parties.
- Stay current on industry trends and the most effective practices to continuously refine the claims management process.
- Collaborate in recognizing workplace dangers and safety risks to proactively avoid future incidents and claims.
Equipment Operated:
- Computer/Laptop
- Basic office equipment
Required Knowledge & Skills:
- Attention to detail and thoroughness of work completed.
- Positive attitude and ability to manage multiple tasks at once.
- Build relationships and maintain them with all levels of employees and external contacts.
- Communication skills (Verbal and written).
- Problem-solving and negotiation skills.
- Timely execution of deliverables.
- Accountability for data reported, and ability to manage time effectively with minimal supervision.
Physical Requirements & Work Environment:
- This position requires occasional lifting and moving of items up to 25 lbs.
- Requires remaining in the seated position for prolonged periods of time.
- Requires repetitive motion of hands.
- Clarity of vision at 20 inches or less.
- Must be able to fulfill essential job functions in a consistent state of alertness and safe manner.
Minimum Education and Experience:
- College degree or equivalent experience.
- Minimum of 3 years of claims management experience, preferably in construction discrepancies or issues
Pay:
The hourly wage range for candidates in this role who will work in Long Beach is $22 to $28. The final wage offered to a successful candidate will be dependent on several factors that may include but are not limited to the type and years of experience within the job, type, and years of experience within the industry, education, etc. Traffic Management, Inc. is a multi-state employer, and this salary may not reflect similar positions in other cities or states.
