Previous Job
Claims Administrator/Manager
Ref No.: 18-10375
Location: Raleigh, North Carolina
Claims Administrator/Manager
Raleigh, NC
Temp to Perm

Need to have B2B Claims Administration

The Claims Administrator/Manager is responsible for overseeing all insurable claims to their most cost-effective resolution by acting as a liaison between company locations, the third-party claims administrator, and vendors from claim inception to conclusion.

Major Responsibilities:
  1. Review and handle casualty claim intake, processing, and associated paperwork, including – in the case of workers compensation claims – claims arising in monopolistic states set up online reporting for all insurable claims into the company's RMIS system.
  2. Conduct frequent and ongoing reviews of each case to ensure the file is updated appropriately, documented timely, and that an aggressive action plan has been implemented to resolve each claim in a timely and cost-efficient manner.
  3. Maintain the integrity, accuracy and thoroughness of claim files.
  4. Maintain a working diary and reminder system to follow up on all open claims in a timely manner.
  5. Review and recommend settlement strategies while maintaining a pro-active approach in controlling the cost of claims.
  6. Maintain and track financial performance for both filing and collection of claims.
  7. Identify problem areas by analyzing the frequency of incidents by type and location.
  8. Create and provide regular claims reports, analysis and loss run reports from various TPA and Risk Management systems. Assist department management in claims loss analysis reviews.
  9. Runs OSHA reports and actuary reports and provide insight to Operational Leadership and Environmental Health and Safety teams on trending accidents and near misses to continue to refine corporate EHS programs to address worker injuries.
  10. Provide oversight to TPA system by monitoring claims and performing monthly reconciliations.
  11. Work as key liaison between the TPA and internal management personnel to include the resolution of claims handling issues or problems.
  12. In addition to the essential job functions described below, all associates will perform duties as requested by management. Assigned responsibilities and duties may vary based upon department growth and evolving operation.

Minimum Qualifications:

  • 4-year degree and claims certification preferred.

  • 3-5 years of experience managing claims

Skills And Abilities
  • Worker's Compensation laws and benefits
  • High attention to detail and accuracy
  • Effective interpersonal communication skills
  • Analyze, solve and respond to questions and problems in a timely manner
  • Maintain confidentiality
  • Handle multiple projects simultaneously within established time constraints
  • Respond professionally to situations with difficult employee/ vendor/ customer issues or inquiries
  • Ability to work within tight deadlines and balance workload effectively
  • Self-motivated and self-directed as well as possess strong time management and organizational skills

  • Proficient with Microsoft Office products as well as database applications