State Fund Claims Manager

Position Summary

The State Fund Claims Managers’ overall objective is to handle workers compensation claims under the direction of the Senior Claims Manager. In addition, this positon requires direct contact with client to communication the best practices for claims management.    

Essential Duties and Responsibilities

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

·         Day to day claims handling.  

·         Handicap Reimbursement – Identify, filing and attendance at hearings.

·         Lump Sum Settlements – Identify, negotiation, customer contact and filing.

·         Review of new injuries: certification/rejection, return to work information.

·         RTW practices – Knowledge of and recommendations to the employer.

·         Client Contact – In person and by phone for current customers.  Also to work with Regional Managers for prospective customers as needed.

·         Employer Education - Knowledge of and communicate to employer regarding cost containment strategies.

·         IME determination, report review and submission.

·         Review of all BWC/IC letters, notices and orders. 

·         Communicate to clientele regarding appeals and responses.

·         Complete analysis of new client’s losses and attend initial “meet and greet” as determined by assigned CRM to discuss claim strategies/plan of action.

·         Review and preparation of hearing files.

·         Attendance for ongoing updates/training internally/externally as deemed necessary by VP of Risk Management.

·         Assist with training new and/or current employees as necessary.

·         Identification and notification of subrogation liens.

·         Other responsibilities as assigned.