Workers’ Compensation Claims Administrator

At Procare HR, we’re committed to changing workforce outcomes for care providers using our industry-focused HR services model! We provide comprehensive HR services to clients including payroll processing, benefits administration, workers compensation management, and general HR support, among other services.

Role Summary

The Workers’ Compensation Claims Manager will proactively manage workers’ compensation claims and internal procedures for assigned clients in conjunction with clients’ staff, adjusters, nurse case managers, and defense counsel with the goal of reducing/controlling claims cost and ultimately, the clients’ Experience Modification Ratings (EMRs). This includes the reporting, investigation, and analysis, litigation management, resolution/outcome management, and the delivery of claim information that are routinely characterized as moderately complex to complex within assigned jurisdiction. This role will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.

Who We Are – Core Values

We strike the gong – Actions have a ripple effect. Every engagement is an opportunity to have a positive impact on our clients and team.

We laugh – Laughter is contagious. Keep it light when things are tough. Life is short, celebrate.

We explore – Individual curiosity and resourcefulness lead us to better solutions.

We show up – Sense of duty and accountability is part of our DNA. How we show up matters.

We are grateful – We are grateful for our clients and for each other, and approach all situations with humility. We appreciate the experiences that have shaped us.

We grow – We embrace the struggle that comes with personal growth so that we can better ourselves and our team.

Our Ideal Candidate

• Has an Associate’s degree in Risk Management (AIC) or related field, preferred
• Comes with 5+ years of progressive experience handling workers’ compensation claims in preferred jurisdictions (FL, SC, NC, TX, GA, MI)
• Has advanced knowledge of workers’ compensation claims functions and processes
• Strong writing and computer skills, especially Outlook and Word
• Thrives in a fast-paced, high-energy environment
• Customer-service focused – we are in the business of caring for people who care for people
• Extremely organized, detail oriented and analytical
• Excellent communicator and problem-solver

What You’ll Be Doing

The essential functions include, but are not limited to the following:

• Client claims management and the oversight of internal procedures.
• Review and analyze reserve information for each claim, particularly at the Unit Statistical Reporting time and communicate details to clients.
• Analyze proposed settlements, prepare settlement evaluations, and communicate its impact on the client’s EMR.
• Provide monthly written report outlining history, status, strategic analysis, and resolution plan of claims to clients.
• Prepare and lead regular in-person claims review meetings at client locations, and/or participate in claims review meetings held by carriers/TPAs.
• Track and review client-specific data, such as EMRs, policy data, loss reports, etc.

Additional Duties & Responsibilities

• Attend litigation proceedings at Workers’ Compensation Boards as needed.
• Review clients’ EMR worksheets and file for corrections as needed.
• Continuously identify claims and/or client concerns and make recommendations for improvements.

The Perks

• Flexibility!
• Health insurance, with the company paying the single employee premium
• Company paid dental insurance
• Company paid life insurance
• Company paid short- and long-term disability insurance
• A 401K plan with company match
• Paid Time Off
• Additional ancillary benefits including Vision, Cancer, Critical Illness, Hospital Indemnity, Voluntary Life/AD&D, Accident and Legal

This job posting contains some general information about what it is like to work at Procare HR and is not a complete job description. Procare Team Members perform a number of different tasks every day, and this posting does not list all of the essential functions of the job.