Director, Workers' Compensation Claims - Commercial Lines Large WV Team
Company: Encova Insurance
Location: Charleston
Posted on: April 24, 2024
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Job Description:
The salary range for this job posting is $94,784.00 -
$151,654.00 annually + bonus + benefitsThe above represents the
salary range for this job requisition. Ultimately, in determining
your pay, we'll consider your location, education, experience, and
other job-related factors. Your recruiter can share more
information about the specific salary range during the hiring
process.This role will report to a Regional Vice President,
Commercial Lines and may work a hybrid schedule in our Charleston,
West Virginia office. We will consider candidates outside of WV who
are willing to work in the Charleston, WV office on a designated
hybrid schedule.JOB OBJECTIVE:The Director, Workers' Compensation
Claims is responsible for oversight of the day-to-day performance
of the business team claims adjusters, return-to-work specialists,
and nurse case managers. In the regional offices, the safety & loss
control consultants (SLC) on the business team will also have a
dotted line report to this position.This position's objective is to
provide leadership that assures superior, cost-effective service
and compliance with adopted best claims practices, and loss control
practices if applicable, to eliminate unwarranted loss.ESSENTIAL
FUNCTIONS: 1. Supervise claims management activities for the
business team members.2. Ensure that new policyholders are properly
on-boarded. Track these results using Encova systems.3. Evaluate
and assign claims to team adjusters, following proper protocols.4.
Provide guidance to assist with identification of possible
complications related to developing injury/exposure claims.5.
Assure establishment of appropriate reserve values throughout the
life of the claim. Approve and adjust reserves as necessary.6.
Consult with internal/external medical, legal, and vocational
professionals on current and/or recommended treatment, litigation
or rehabilitation plans to assist the adjuster in reaching
achievable and appropriate claim outcome.7. Analyze medical, legal
and vocational rehabilitation reports compared to established
guidelines. Advise staff on findings outside of established
guidelines.8. Supervise and assist business team claims staff with
investigation, evaluation and settlement of assigned claims thru
application of technical knowledge and human relation skills to
effect fair and prompt claim closure and to contribute to a reduced
loss ratio.9. Support and assist claims staff with the
investigation and pursuit of subrogation recoveries.10. Participate
in claim discussions at team staffing. Provide guidance when
needed.11. Represent the organization on special projects; carry
out speaking engagements for local meetings or conferences.12.
Train and mentor new associates on claims and unit procedures.13.
Work collaboratively with team adjusters, outside counsel, injured
employee, employer, health and rehabilitation professionals to
manage claim costs, promote quality medical care and timely
return-to-work (RTW) to achieve optimum cost-effective medical and
vocational outcomes.14. Perform file reviews for claims staff as
part of the Quality Assurance program to assure that claims are
being handled in accordance with the company's set best
practices.15. Facilitate meetings with policyholders, both
independent of and in concert with the Business Director.16. Work
collaboratively with Claims Operations and the Best Practice Leader
on projects involving claim policies, procedures and best
practices.17. Identify, develop, and analyze claims-related reports
to assist and advise the Business Director of current and future
profitability outcomes.18. If SLC oversight is part of
responsibility, perform periodic ride-alongs with SLC Specialists
to ensure proper loss prevention and mitigation is being delivered
to Encova customers.19. If SLC oversight is part of responsibility,
participate in SLC performance review conversations with the
Business Director.OTHER FUNCTIONS: 1. Non-essential function: other
duties as assigned.KNOWLEDGE, SKILLS AND ABILITIES:* Bachelor's
degree from an accredited college or university preferred. * Five
years of insurance experience with a private carrier, former
workers' compensation commission, agency or third-party
administrator required. * Preference may be shown to a candidate
with multiple state insurance experience.* Preference may be shown
to a candidate with claims adjusting, case management, or safety
and loss control experience.* Preference may be shown to a
candidate with previous managerial experience.* Must hold or be
eligible to obtain an adjuster's license in applicable states.*
Must pass the claims adjuster license exam(s) for applicable states
within six months of being hired.* Demonstrate the ability to
motivate people toward a common goal.* Proven record of providing
support as mentor and resource for fellow team members.* Proven
record of effective communication.* Advanced knowledge of workers
compensation insurance practices, statute, precedents and
government regulations.* Understand the implications of both
current and future decisions.* Combine pieces of information to
form general rules or conclusions.* Uses logic and reasoning to
identify strengths and weaknesses of alternative solutions,
conclusions, or approaches to problems.* Can translate and explain
the meaning of information presented and how that information may
be used to effectively make decisions and develop strategies.* Can
evaluate relative costs and benefits of potential actions to choose
the best action.* Can bring parties together to reconcile
differences.* Effectively manages time without direct supervision.*
Use relevant information and expertise to determine whether events
or processes comply with laws, regulations or standards.* Analyze
information and evaluates results to choose the best solution.*
Identify complex problems and reviews related information to
develop and evaluate options and implement solutions.* Work
effectively in a team environment.* Able to arrange items or
actions in a certain order or pattern according to a specific rule
or set of rules.* Understand how claim costs affect loss ratios,
the overall profitability of an account and ultimately, a book of
business.* If SLC oversight is part of responsibility, understand
how claim, incident and near miss frequency impacts future loss
activity and ultimately the profitability of an account/book of
business.* Ability to work effectively in a paperless
environment.This position has been evaluated in accordance with the
Americans with Disabilities Act. Encova Insurance makes every
effort to reasonably accommodate disabilities to permit performance
of the essential functions and candidates who need such
accommodation are encouraged to seek it. This description reflects
the nature and level of work performed by associates in this
position. It is not an all-inclusive inventory of duties,
responsibilities and qualifications required. It provides an
accurate overview of the work and skills needed to perform this
position. Because job content may change from time to time, Encova
Insurance reserves the right to add and/or delete functions from
this job as it deems necessary for business reasons.Ready to join
our team?
At Encova Insurance, we firmly believe that our associates drive
our company's success by delivering unrivaled service to our
customers. With success in mind, we make an ongoing effort to
provide an environment that offers challenging, stimulating and
financially rewarding opportunities.
Join us to discover a work experience where your diverse ideas will
be met with enthusiasm - where you can learn and grow to your
fullest potential.What you can expect from usJoin our family of
industry leaders, and let us reward you with a competitive salary,
bonus and benefits package that includes but is not limited to: a
401(k), wellness programs, bonus incentive plans and flexible
schedules, with an early close of the office every Friday.
Additionally, Encova aspires to be an outstanding corporate citizen
in all the markets we serve; we encourage and support associate
participation in community initiatives through our
foundations.Encova Insurance is an EOE/E-Verify employer.
Keywords: Encova Insurance, Charleston , Director, Workers' Compensation Claims - Commercial Lines Large WV Team, Executive , Charleston, West Virginia
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