Workers' Comp Claims Consultant/Analyst - TPA Oversight

ADP is hiring a Lead Claims Examiner. In this position you will perform the following basic functions:

• Supervisory responsibility for Claims Examiner I and Senior Examiner
• To aid in overall claim cost reduction by coordinating efforts between all involved vendors, clients and WES.
• Additional level to monitor applicable claims assigned to Claims Examiner I and Senior Examiner
• To ensure TPA/Carrier accountability in agreed performance standards and coordinate needs for changes with Claims Director
• To accumulate data for the purpose of creating standards for measurement of various claim related issues, as well as customer service and internal staff performance

RESPONSIBILITIES:

• Reviews and recommends acceptability of all Workers' Compensation Claims within claim distribution
• Accountability for the Claim Unit's efforts in all RTW efforts, OSHA documentation and all documentation of claim activity according to stated claim procedures.
• Works directly with Claims Director to determine workloads and the necessity of procedure changes within the Claims Unit
• Assists in online audits of TPA to insure quality compliance of claim procedures and client satisfaction in Workers' Compensation claims handling.
• Maintaining e-time and PTO/Sick time coordination for the Claims Unit., has one administrative direct report and mentor/coaching responsibilities for the Claims Examiner.
• Responsible for communication with internal/external clients, claimants, related vendors as well as TPA/Carrier activity for TotalSource work-site employee claims to include personal visits to each region.
• Requires basic knowledge of Workers' Compensation laws for all jurisdictions.
• Attends professional development courses and seminars to keep TotalSource current with related workers' compensation laws and standards.
• Represents client in legal activities related to Workers' Compensation Claims within authority.
• To review, audit and support the examiner positions.
• To generate routine reports for productivity level evaluation.
• To support the Claims Director in daily/monthly/quarterly tasks and projects that aid in the claim operation reach it's specified goals.

QUALIFICATIONS REQUIRED:

• 5+ years in WC Indemnity adjusting or industry related experience
• Experience with complex claims cases
• Strong Excel experience
• Strong analytical skills
• Direct or indirect leadership experience- training, mentoring

PREFERRED QUALIFICATIONS: Preference will be given to candidates who have the following:

• PEO experience
• Maintain knowledge of basis Workers Compensation Laws in all applicable jurisdictions
• Stay abreast of strategies and current industry related ideologies in dealing with Workers' Compensation Claims
• Maintain adequate resources to enable continued education in Workers' Compensation and RTW issues.

#LI-KD1 #LI-Remote Base salary offers for this position may vary based on factors such as location, skills, and relevant experience. Some positions may include additional compensation in the form of bonus, equity or commissions. We offer the following benefits: Medical, Dental, Vision, Life Insurance, Matched Retirement Savings, Wellness Program, Short-and Long-Term Disability, Charitable Contribution Match, Holidays, Personal Days & Vacation, Paid Volunteer Time Off, and more. The compensation for this role is USD $59,100.00 - USD $120,200.00 / Year* • Actual compensation will not be less than the applicable minimum wage or minimum exempt salary requirement under federal, state and local laws. A little about ADP: We are a comprehensive global provider of cloud-based human capital management (HCM) solutions that unite HR, payroll, talent, time, tax and benefits administration and a leader in business outsourcing services, analytics, and compliance expertise. We believe our people make all the difference in cultivating a down-to-earth culture that embraces our core values, welcomes ideas, encourages innovation, and values belonging. We've received recognition for our work by many esteemed organizations, learn more at ADP Awards and Recognition. Diversity, Equity, Inclusion & Equal Employment Opportunity at ADP: ADP is committed to an inclusive, diverse and equitable workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including: race, color, genetic information, creed, national origin, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, ancestry, age, marital status, protected veteran status or disability. Hiring decisions are based upon ADP’s operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance. Ethics at ADP: ADP has a long, proud history of conducting business with the highest ethical standards and full compliance with all applicable laws. We also expect our people to uphold our values with the highest level of integrity and behave in a manner that fosters an honest and respectful workplace. Click https://jobs.adp.com/life-at-adp/ to learn more about ADP’s culture and our full set of values. Apply tot his job Apply To this Job