County: CCAP

Job Description

Claims Representative 2: Workers’ Compensation POSITION DESCRIPTION The PComp Claims Representative 2 handles workers' compensation claims, investigates, evaluates, and establishes reserves for those claims. Duties also include expense control, vendor monitoring, some litigation management and resolution of claims. The Claims Rep 2 will also be able to provide information to members, producers and others regarding coverage, claim status and procedures of the claims assigned to them. The PComp Claims Representative 2 typically handles medical only claims, and short term lost time claims, and does not typically handle many litigated claims. Some reports to reinsurers may be required. The PComp Claims Representative 2 performs work with moderate supervision and reports directly to the Senior Claims Supervisor general direction, settlement authority and work evaluations. The PComp Claims Representative 2 will also require direct supervision on all litigation files and excess reportable files. The PComp Claims Representative 2 will also provide support for all general operations of CCAP including but not limited to: assisting with mailings, attendance and assistance at trainings, attendance at PComp board meetings, preparation of board reports, and other duties as assigned. The PComp Claims Representative 2 will also participate in the short and long range planning for the CCAP Claims Unit as well as the CCAP Insurance Department. RESPONSIBILITIES The PComp Claims Representative 2's general responsibilities include: • Manages selected workers' compensation claims. • Investigates, evaluates, and establishes reserves for workers' compensation claims. • Establishes claims files in RiskMaster, set diaries, maintains up to date notes, attaches documents and establishes proper reserving for claims. • Monitors files in litigation, reviews defense counsel bills for payment. • Provides information to PComp members, local insurance producers and others regarding coverage, claim status and procedures of their claims. • Processing work comp bureau documents in WCAIS. • Supervision and communication with PComp defense counsel related to specific claims. • Familiarity with the Claims Manual for CCAP Insurance Programs, and adherence to its procedures for workers' compensation claims handling. • Preparation of required reports for insurance regulators. • Preparation of reports for CCAP program boards of directors and committees. • Assistance with training and educational sessions for program board members and participants. • Performance of other assignments and routine business of the association. QUALIFICATIONS Two to four years of related work experience as a workers' compensation claims representative is required, a college degree in business, insurance or related fields is preferred. Familiarity with a computer claims management system is required. Strong time management and organizational skills are essential. ESSENTIAL PHYSICAL REQUIREMENTS Occasional travel to CCAP trainings, member visits, board meetings will be required, sometimes overnight. The position also requires the ability to operate computer equipment essential to the completion of the position's responsibilities. FLSA For purposes of the Fair Labor Standards Act this is a non-exempt position. To apply and be considered for the position, please submit your cover letter, resume and professional references to employment@pacounties.org by May 20, 2019.

Deadline Date: Monday, May 20, 2019

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