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This is a full time, 40-hour per week, claim manager position in the Tumwater, Tacoma, or Spokane office. Manages caseload of approximately 140 workers’ compensation claims to ensure consistency with state WAC, RCW, and Labor and Industries policy. Provides service to clients which maximizes efficiency of their workers’ compensation program. Advises Washington State employers on workers’ compensation best practices. Engages and works as a team with both external and internal clients to achieve results. The focus of this job is on achieving results that are aligned with the larger picture of the organization and its strategic goals. Initiative, coupled with a sense of competitive drive, and the ability to stay focused on results despite changing conditions, is the key to achieving performance objectives of this job. The work involves innovation and creativity in generating ideas for quick response. Decision making is focused on implementing practical, timely solutions. The job requires getting things done quickly and handling a variety of activities. Self-assurance, and the confidence to purposefully drive toward results while constantly problem-solving and engaging the commitment of others is essential. The emphasis on building rapport and relationships with individuals and groups requires an outgoing, poised, and persuasive communication style. Because the pace of the work is faster than average, the ability to learn quickly and thoroughly while continually recognizing and adapting to changing conditions is critical. Emphasis is on results, and effective systems that achieve results through and with people, rather than on the details of implementation. The job environment is flexible, constantly changing and provides growth opportunity, recognition, and reward for the achievement of business results.
Responsibilities Include (but are not limited to):
- Review and analyze all documents pertaining to newly filed workers’ compensation claims including report of accident, chart notes, witness statements, work restrictions, etc.
- Initiate contact with employer clients to discuss new claims, expected duration, return to work, and strategic plan
- Help employer clients identify light duty work and put together job descriptions for appropriate work
- Aid employer clients with accident and validity investigation
- Conduct in-depth review and analysis including validity investigation, mechanism of injury, objective findings, wage calculations, return to work strategy, and development
- Educate regarding Retrospective Rating and impact on insurance rates and retro refund
- Create regular, detailed strategic plans identifying appropriate actions which drive claims to closure
- Teach employers and assist with making valid offers of employment
- Communicate with medical providers to obtain work restrictions and communicate work available with a variety of different employers
- Advise clients on best practices to maximize efficacy of their workers’ compensation programs
- Research and analyze complex medical materials including MD Guidelines and AMA Guides to make assessments of causation and treatment provided
- Prepare persuasive written and oral arguments to influence actions on a case
- Partner and strategize with other claims managers, attorneys, claims consultants, investigators, group managers, vocational consultants, HR professionals, and employer clients
- Prepare comprehensive claim staffing forms and orally present claim summaries and plans of action to bring claims to closure
- Triage claims and appropriate identifies priority issues
- Prefer at least five years of industrial insurance experience
- In-depth knowledge of and familiarity with Washington State Workers’ Compensation WAC and RCW
- Rapport and relationship building focused on achieving results
- Ability to engage commitment of others
- Sense of urgency for goal achievement
- Action-oriented and somewhat collaborative decision making
- Ability to make quick decisions in response to changing conditions
- Accountability for results Wages & Benefits:Wage depends on experience and is highly competitive for the industry. Medical, dental, and vision insurance. Short and long-term disability. Competitive vacation and paid time off policy. 401-k with matching.
- Additional benefits based on performance. ERNwest values work/life balance and is structured to reward high performers.
The primary functions of this position are to lead ERNwest clients and staff in returning injured employees to work on temporary or reasonably continuous basis in the safest and fastest manner possible, create accurate job descriptions and job analyses for the purposes of claim adjudication and return to work, and to review private sector vocational rehabilitation services on specific claims. The overarching goal of this position is to help employers keep their employees engaged in the workforce while recovering from work-related injuries in order to reduce the cost of time loss, reduce salary continuation (KOS) payments made by the employer, and significantly increase the employee’s likelihood of an excellent recovery from injury. RTW Managers are typically assigned to a group of ERNwest claim managers and work in concert with the claim managers on return to work and vocational rehabilitation matters. The individual in this position will work directly with clients, speaking on the telephone with clients, working as a team member with ERNwest claims and group management staff, interacting with medical care providers, and working in coordination with other claim(s) stakeholders.
Responsibilities include (but are not limited to):
- Reviewing claims to identify opportunities to assist the ERNwest clients and the ERNwest claims team to return an injured employee to the workplace
- Working directly with ERNwest clients developing temporary/transitional and reasonably continuous positions; this may include:
- Assisting the employer in identifying job tasks that provide value to the employing organization.
- Identifying short term training reimbursable by the WSAW and other programs
- Assisting with job offer letters and language used to ensure validity
- Requesting preferred worker status on behalf of an injured employee as well as assisting the employer with obtaining preferred worker status for the job offered from the Department of Labor and Industries
- In concert with the assigned ERNwest claim manager, intervening in and maintaining a presence on claims with lost or restricted days
- Receiving internal referrals from ERNwest claim manager to create job analyses, job descriptions, initiate return to work services, or assist with a vocational review of a Workers’ Compensation claim
- Training ERNwest claim managers on return to work requirements, techniques, strategies and practices for basic return to work with the employer.
- Assisting in developing return to work programs or materials for employers and Retrospective Rating group programs
- Using the required measurement tools and training work with employers to create accurate job analyses that describe the essential functions and the associated physical demands of a job the employer currently has or may offer
- Discussing the need of vocational rehabilitation and early return to work referrals with L&I claim managers, vocational, and early return to work staff
- Participating in ERNwest claim staffing conferences
- Reviewing all cases reaching/approaching plan development
- Preparing, submitting, and following through with disputes to private sector vocational recommendations using appropriate WAC and RCW to support disputes
- Experience as a vocational rehabilitation counselor in the State of Washington
- Sufficient computer skills to use common applications such as MS Word, Excel, and web browsers
- Maintain a valid Washington State driver’s license.
- Write and speak English fluently.
- Provide excellent internal and external customer service to client companies, group managers, and claims staff
- Be self-directed and demonstrate the ability to work in small and large teams
- Demonstrate ability to communicate well in person, via email and via telephone.
- Salary is dependent on applicable work experience
- 100% company paid health, dental, vision
- 401k with match
- Long-term and short-term disability
- 12 paid holidays
- Paid vacation
- Paid sick leave
- Flexible work schedule