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Form of workSalary : $73,378.12 - $117,111.32 Annually
Location : Fort Lauderdale, FL
Job Type: Full-Time
Job Number: 1411594
Department: FASD Risk Mgmt Workers Comp
Opening Date: 12/14/2023
Closing Date: Continuous
Veterans' Preference Notice: Under Section 295.07, Florida Statutes, certain servicemembers and veterans, and the spouses and family members of such servicemembers and veterans, receive preference and priority, and certain servicemembers may be eligible to receive waivers for postsecondary educational requirements, in employment with Broward County and are encouraged to apply for the positions being filled.
REQUIREMENTS AND PREFERENCES
The Broward County Board of County Commissioners is seeking qualified candidates for Workers' Compensation Claims Manager.
Specifically this position:
Develops and manages the County's self-insured Workers' Compensation Claims Section administered by the Risk Management Division.
Works independently, under limited supervision, reporting major activities through periodic meetings and executive reporting.
The functions listed below are those that represent the majority of the time spent working in this class. Management may assign additional functions related to the type of work of the job as necessary.
Manages the operations of the County's self-insured Workers' Compensation Section; directs through subordinates the planning, adjudication, and resolution efforts of all Workers' Compensation claim adjusting activities.
Ensures that the Risk Management Division meets all State of Florida annual reporting and Electronic Data Interchange (EDI) requirements. In addition, the Center for Medicare Services (CMS) requires continuous, accurate, input of ICD-10 Diagnosis Codes.
Establishes "best practices" procedures, provides training to subordinates, and ensures compliance with established procedures.
Reviews complex claims, recommends appropriate action, and adjusts complex claims as necessary; provides technical expertise to in-house adjusting staff in all aspects of claims administration laws, rules, regulations, and practices.
Coordinates claim settlement board agenda items to ensure timely settlement of claims; prepares and delivers oral presentations to County agencies and upper management regarding claims-related rules, regulations, policies, and procedures.
Runs reports, on a regular basis, to identify negative trends for the purpose of implementing solutions.
Performs related work as assigned.
General Description
Develops and manages the County's self-insured Workers' Compensation Section administered by the Risk Management Division.
Works independently, under limited supervision, reporting major activities through periodic meetings.
Minimum Education and Experience Requirements
Requires two (2) years equivalent of higher-level education in insurance, risk management, or closely related field.
(One Year of relevant experience may be substituted for each year of required education.)
Requires six (6) years investigating/adjusting Workers' Compensation and/or General Liability claims, including three (3) years claims adjusting within the State of Florida, including two (2) years of lead work/supervisory experience.
Special Certifications and Licenses
Must possess and retain a Florida All-Lines Adjuster's License (Type 6-20 or 7-20) from the State of Florida Division of Insurance Agent and Agency Services.
Preferences
Master's degree from an accredited college in relevant field.
Board Certification in Workers' Compensation & Litigation Management (CWCL).
Minimum of 2 years experience in recorded statements, Associate in Claims (AIC), Associate in Insurance Services (AIS) or Accredited Advisor in Insurance (AAI).
Associate in Risk Management (ARM), Certified Insurance Service Representative (CISR) or Certified Risk Manager (CRM).
Certified Insurance Counselors (CIC) or Chartered Property Casualty Unerwriter (CPCU).
Certification in Workers' Compensation (CWC).
Experience in Workers' Compensation cost saving measures for program efficiency.
Accredited Claims Adjuster (ACA).
Minimum of 2 years' experience negotiating Workers' Compensation lien recoveries.
Minimum of 2 years' experience responding to Conditional Payment demands from the Center for Medicare Services (CMS).
Minimum of 5 years in utilizing data and analytics to identify trends and improve business results.
DUTIES AND RESPONSIBILITIES
The functions listed below are those that represent the majority of the time spent working in this class. Management may assign additional functions related to the type of work of the job as necessary.
Manages the operations of the County's self-insured Workers' Compensation Section; directs through subordinates the planning, scheduling and coordination of all Workers' Compensation Claims adjusting activities.
Ensures that Risk Management Division meets all State of Florida Workers' Compensation Claims reporting and requirements; establishes "best practices" procedures, provides training to subordinates and ensures compliance with established procedures.
Reviews complex claims, recommends appropriate action, and adjusts complex claims as necessary; provides technical expertise to in-house adjusting staff in all aspects of Workers' Compensation Claims administration laws, rules, regulations and practices.
Coordinates claim settlement board agenda items to ensure timely settlement of claims; prepares and delivers oral presentations to County agencies and upper management regarding Workers' Compensation rules, regulations, policies and procedures.
Runs reports, on a regular basis, to identify negative trends for the purpose of implementing solutions.
Remains in daily contact with injured workers, supervisors and managers from all over the County, to ensure a comfortable Workers' Compensation experience.
Performs related work as assigned.
WORK ENVIRONMENT
Physical Demands
Physical demands refer to the requirements for physical exertion and coordination of limb and body movement.
Performs sedentary work that involves walking or standing some of the time and involves exerting up to 10 pounds of force on a regular and recurring basis or sustained keyboard operations.
Unavoidable Hazards (Work Environment)
Unavoidable hazards refer to the job conditions that may lead to injury or health hazards even though precautions have been taken.
None.
SPECIAL INFORMATION
County Core Competencies
All Broward County employees strive to demonstrate the County's four core behavioral competencies.
Americans with Disabilities Act (ADA) Compliance
Broward County is an Equal Opportunity Employer committed to inclusion. Broward County is committed to providing equal opportunity and reasonable accommodations to qualified persons with disabilities. We support the hiring of people with disabilities; therefore, if you require assistance due to a disability, please contact the Professional Standards Section in advance at 954-357-6500 or email Profstandards@broward.org to make an accommodation request.
Emergency Management Responsibilities
Note: During emergency conditions, all County employees are automatically considered emergency service workers. County employees are subject to being called to work in the event of a disaster, such as a hurricane, or other emergency situation and are expected to perform emergency service duties, as assigned.
County-wide Employee Responsibilities
All Broward County employees must serve the public and fellow employees with honesty and integrity in full accord with the letter and spirit of Broward County's Employee Code of Ethics, gift, and conflict of interest policies.
All Broward County employees must establish and maintain effective working relationships with the general public, co-workers, elected and appointed officials and members of diverse cultural and linguistic backgrounds, regardless of race, color, religion, sex, national origin, age, disability, marital status, political affiliation, familial status, sexual orientation, pregnancy, or gender identity and expression.
Broward is a dynamic county that offers an exciting, stable career with incredible employee benefits such as 11 annual holidays, accrued annual/vacation and sick leave, FRS retirement, $50,000 of free life insurance, training and development, and participation eligibility in a deferred compensation (457) plan with a match up to $2,000. In addition, Broward County offers 2 health plans, a High Deductible Health Plan (HDHP) with a County-funded Health Savings Account (HSA), and a Consumer Driven Health plan (CDH), Dental insurance, Vision insurance and Section 125 Flexible spending accounts for Medical Expenses and Dependent Care. Part-time 20+ benefit eligible employees receive the benefits described above at a reduced amount.
01
Please describe your experience investigating and settling Workers' Compensation Claims utilizing Florida Statute 440. How did you obtain this experience?
02
What is the highest number of adjusters and claims support employees you have supervised? How were teams organized to maximize productivity and client servicing?
03
What experience do you have with State audits? What are "category fines" and what actions have you taken to address and avoid these?
04
Please describe your Electronic Data Interchange (EDI) and Center for Medicare Services (CMS) coding experience. What controls assured timely compliance? How were Diagnosis Codes (ICD-10) populated in your RMIS experience.
05
What experience do you have communicating claims status with client agencies, outside of scheduled claims reviews? The client couldn't reach the adjuster and was forwarded to you for assistance, how did you handle?
06
What Risk Management Information Systems (RMIS) do you have experience with?
07
Explain any experience you have with RIMS implementation or modification to meet specific company or staff needs?
08
What new implemented process, system parameters, or technology have proven more successful for your operations and why?
09
What techniques or methods, either manually or by computer, have you utilized to manage a large volume of claims to maximize productivity and customer service.
Required Question
Location : Fort Lauderdale, FL
Job Type: Full-Time
Job Number: 1411594
Department: FASD Risk Mgmt Workers Comp
Opening Date: 12/14/2023
Closing Date: Continuous
Veterans' Preference Notice: Under Section 295.07, Florida Statutes, certain servicemembers and veterans, and the spouses and family members of such servicemembers and veterans, receive preference and priority, and certain servicemembers may be eligible to receive waivers for postsecondary educational requirements, in employment with Broward County and are encouraged to apply for the positions being filled.
REQUIREMENTS AND PREFERENCES
The Broward County Board of County Commissioners is seeking qualified candidates for Workers' Compensation Claims Manager.
Specifically this position:
Develops and manages the County's self-insured Workers' Compensation Claims Section administered by the Risk Management Division.
Works independently, under limited supervision, reporting major activities through periodic meetings and executive reporting.
The functions listed below are those that represent the majority of the time spent working in this class. Management may assign additional functions related to the type of work of the job as necessary.
Manages the operations of the County's self-insured Workers' Compensation Section; directs through subordinates the planning, adjudication, and resolution efforts of all Workers' Compensation claim adjusting activities.
Ensures that the Risk Management Division meets all State of Florida annual reporting and Electronic Data Interchange (EDI) requirements. In addition, the Center for Medicare Services (CMS) requires continuous, accurate, input of ICD-10 Diagnosis Codes.
Establishes "best practices" procedures, provides training to subordinates, and ensures compliance with established procedures.
Reviews complex claims, recommends appropriate action, and adjusts complex claims as necessary; provides technical expertise to in-house adjusting staff in all aspects of claims administration laws, rules, regulations, and practices.
Coordinates claim settlement board agenda items to ensure timely settlement of claims; prepares and delivers oral presentations to County agencies and upper management regarding claims-related rules, regulations, policies, and procedures.
Runs reports, on a regular basis, to identify negative trends for the purpose of implementing solutions.
Performs related work as assigned.
General Description
Develops and manages the County's self-insured Workers' Compensation Section administered by the Risk Management Division.
Works independently, under limited supervision, reporting major activities through periodic meetings.
Minimum Education and Experience Requirements
Requires two (2) years equivalent of higher-level education in insurance, risk management, or closely related field.
(One Year of relevant experience may be substituted for each year of required education.)
Requires six (6) years investigating/adjusting Workers' Compensation and/or General Liability claims, including three (3) years claims adjusting within the State of Florida, including two (2) years of lead work/supervisory experience.
Special Certifications and Licenses
Must possess and retain a Florida All-Lines Adjuster's License (Type 6-20 or 7-20) from the State of Florida Division of Insurance Agent and Agency Services.
Preferences
Master's degree from an accredited college in relevant field.
Board Certification in Workers' Compensation & Litigation Management (CWCL).
Minimum of 2 years experience in recorded statements, Associate in Claims (AIC), Associate in Insurance Services (AIS) or Accredited Advisor in Insurance (AAI).
Associate in Risk Management (ARM), Certified Insurance Service Representative (CISR) or Certified Risk Manager (CRM).
Certified Insurance Counselors (CIC) or Chartered Property Casualty Unerwriter (CPCU).
Certification in Workers' Compensation (CWC).
Experience in Workers' Compensation cost saving measures for program efficiency.
Accredited Claims Adjuster (ACA).
Minimum of 2 years' experience negotiating Workers' Compensation lien recoveries.
Minimum of 2 years' experience responding to Conditional Payment demands from the Center for Medicare Services (CMS).
Minimum of 5 years in utilizing data and analytics to identify trends and improve business results.
DUTIES AND RESPONSIBILITIES
The functions listed below are those that represent the majority of the time spent working in this class. Management may assign additional functions related to the type of work of the job as necessary.
Manages the operations of the County's self-insured Workers' Compensation Section; directs through subordinates the planning, scheduling and coordination of all Workers' Compensation Claims adjusting activities.
Ensures that Risk Management Division meets all State of Florida Workers' Compensation Claims reporting and requirements; establishes "best practices" procedures, provides training to subordinates and ensures compliance with established procedures.
Reviews complex claims, recommends appropriate action, and adjusts complex claims as necessary; provides technical expertise to in-house adjusting staff in all aspects of Workers' Compensation Claims administration laws, rules, regulations and practices.
Coordinates claim settlement board agenda items to ensure timely settlement of claims; prepares and delivers oral presentations to County agencies and upper management regarding Workers' Compensation rules, regulations, policies and procedures.
Runs reports, on a regular basis, to identify negative trends for the purpose of implementing solutions.
Remains in daily contact with injured workers, supervisors and managers from all over the County, to ensure a comfortable Workers' Compensation experience.
Performs related work as assigned.
WORK ENVIRONMENT
Physical Demands
Physical demands refer to the requirements for physical exertion and coordination of limb and body movement.
Performs sedentary work that involves walking or standing some of the time and involves exerting up to 10 pounds of force on a regular and recurring basis or sustained keyboard operations.
Unavoidable Hazards (Work Environment)
Unavoidable hazards refer to the job conditions that may lead to injury or health hazards even though precautions have been taken.
None.
SPECIAL INFORMATION
County Core Competencies
All Broward County employees strive to demonstrate the County's four core behavioral competencies.
- Collaborates: Building partnerships and working collaboratively with others to meet shared objectives.
- Customer focus: Building strong customer relationships and delivering customer-centric solutions.
- Instills trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity.
- Values differences: Recognizing the value that different perspectives and cultures bring to an organization.
Americans with Disabilities Act (ADA) Compliance
Broward County is an Equal Opportunity Employer committed to inclusion. Broward County is committed to providing equal opportunity and reasonable accommodations to qualified persons with disabilities. We support the hiring of people with disabilities; therefore, if you require assistance due to a disability, please contact the Professional Standards Section in advance at 954-357-6500 or email Profstandards@broward.org to make an accommodation request.
Emergency Management Responsibilities
Note: During emergency conditions, all County employees are automatically considered emergency service workers. County employees are subject to being called to work in the event of a disaster, such as a hurricane, or other emergency situation and are expected to perform emergency service duties, as assigned.
County-wide Employee Responsibilities
All Broward County employees must serve the public and fellow employees with honesty and integrity in full accord with the letter and spirit of Broward County's Employee Code of Ethics, gift, and conflict of interest policies.
All Broward County employees must establish and maintain effective working relationships with the general public, co-workers, elected and appointed officials and members of diverse cultural and linguistic backgrounds, regardless of race, color, religion, sex, national origin, age, disability, marital status, political affiliation, familial status, sexual orientation, pregnancy, or gender identity and expression.
Broward is a dynamic county that offers an exciting, stable career with incredible employee benefits such as 11 annual holidays, accrued annual/vacation and sick leave, FRS retirement, $50,000 of free life insurance, training and development, and participation eligibility in a deferred compensation (457) plan with a match up to $2,000. In addition, Broward County offers 2 health plans, a High Deductible Health Plan (HDHP) with a County-funded Health Savings Account (HSA), and a Consumer Driven Health plan (CDH), Dental insurance, Vision insurance and Section 125 Flexible spending accounts for Medical Expenses and Dependent Care. Part-time 20+ benefit eligible employees receive the benefits described above at a reduced amount.
01
Please describe your experience investigating and settling Workers' Compensation Claims utilizing Florida Statute 440. How did you obtain this experience?
02
What is the highest number of adjusters and claims support employees you have supervised? How were teams organized to maximize productivity and client servicing?
03
What experience do you have with State audits? What are "category fines" and what actions have you taken to address and avoid these?
04
Please describe your Electronic Data Interchange (EDI) and Center for Medicare Services (CMS) coding experience. What controls assured timely compliance? How were Diagnosis Codes (ICD-10) populated in your RMIS experience.
05
What experience do you have communicating claims status with client agencies, outside of scheduled claims reviews? The client couldn't reach the adjuster and was forwarded to you for assistance, how did you handle?
06
What Risk Management Information Systems (RMIS) do you have experience with?
07
Explain any experience you have with RIMS implementation or modification to meet specific company or staff needs?
08
What new implemented process, system parameters, or technology have proven more successful for your operations and why?
09
What techniques or methods, either manually or by computer, have you utilized to manage a large volume of claims to maximize productivity and customer service.
Required Question
