Workers' Compensation Claims Manager jobs in Appleton, WI

Workers' Compensation Claims Manager manages accountabilities in the administration of first and third party worker's compensation claims. Manages domestic and/or international claim management strategies critical to the organization's success. Being a Workers' Compensation Claims Manager is responsible for reporting, investigation, and analysis; litigation management; resolution/outcome management; and the delivery of claim information. Manages litigated and moderately complex claims and is entrusted with significant settlement authority. Additionally, Workers' Compensation Claims Manager creates and develops relationships with claims adjusters, insurers, outside legal counsel, and other claims related parties. Directs workers' compensation claims policies and procedures within the claim information analysis. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Workers' Compensation Claims Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Workers' Compensation Claims Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Claims Associate - Workers Compensation / Medical-Only (Wausau, WI)
  • Sedgwick
  • Wausau, WI FULL_TIME
  • The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia.
    Claims Associate - Workers Compensation / Medical-Only (Wausau, WI)
    IF YOU CARE, THERE’S A PLACE FOR YOU HERE

    For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.
    For more than 50 years, Sedgwick has been helping employers answer virtually every question there is about workers’ compensation. We have experience in nearly every type of industry and region and provide the industry’s broadest range of programs and services.
    PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
    * Candidates must be commutable to the Wausau, WI office *
    BENEFITS
    Competitive hourly rates
    Flexible work schedule
    Referral Incentive Program
    Internal career progression and development
    Benefits eligibility and 401(k) with company match day 1
    ESSENTIAL FUNCTIONS and RESPONSIBILITIES
    • Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
    • Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
    • Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
    • Administers subrogation of claims and negotiates settlements.
    • Communicates claim action with claimant and client.
    • Ensures claim files are properly documented and claims coding is correct.
    • May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
    • Maintains professional client relationships.
    ADDITIONAL FUNCTIONS and RESPONSIBILITIES
    • Performs other duties as assigned.
    • Supports the organization's quality program(s).
    • Travels as required.
    QUALIFICATIONS
    Education & Licensing
    Bachelor's degree from an accredited college or university preferred.
    Experience
    Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
    Skills & Knowledge
    • Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
    • Excellent oral and written communication, including presentation skills
    • PC literate, including Microsoft Office products
    • Analytical and interpretive skills
    • Strong organizational skills
    • Good interpersonal skills
    • Ability to work in a team environment
    • Ability to meet or exceed Service Expectations
    WORK ENVIRONMENT
    When applicable and appropriate, consideration will be given to reasonable accommodations.
    Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
    Physical: Computer keyboarding, travel as required
    Auditory/Visual: Hearing, vision and talking
    NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
    The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. #LI-Onsite
    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
  • 7 Days Ago

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Workers' Compensation Underwriter
  • Berkley
  • Appleton, WI OTHER
  • Company Details Berkley Asset Protection was established in 2008 to deliver the industry’s most complete and high-quality portfolio of specialized insurance products and services to protect fine art, ...
  • 12 Days Ago

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Roofing Claims Specialist - $60-$200k Compensation
  • AmeriPro Roofing
  • Appleton, WI FULL_TIME
  • AmeriPro Roofing, one of the largest residential roofing contractors in the nation is immediately Hiring Outside Sales Representatives in the Oshkosh, Green Bay and Appleton areas! Outside Sales Repre...
  • 5 Days Ago

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Compensation Manager, Kohler Energy
  • kohler
  • Kohler, WI FULL_TIME
  • Location: Hybrid at Kohler Energy, WIOpportunityThe Compensation Manager will be responsible for establishing and leading the Compensation function within our organization, partnering closely with sen...
  • 1 Month Ago

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Shipping and Receiving Clerk
  • The Workers LLC
  • Neenah, WI FULL_TIME
  • We are seeking a Shipping and Receiving clerk to join our team in Neenah, WI. The Shipping and Receiving Clerk is responsible for preparing outgoing shipments and receiving incoming shipments. Their d...
  • 11 Days Ago

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Inventory Control/Parts Specialist
  • The Workers LLC
  • Neenah, WI FULL_TIME
  • The Workers LLC is a leading food equipment distributor in the state of Wisconsin. The company has been in business for over 30 years. We pride ourselves on being professional and offering our custome...
  • 23 Days Ago

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0 Workers' Compensation Claims Manager jobs found in Appleton, WI area

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Lathe Machinist
  • Kimberly-clark
  • Appleton, WI
  • Machinist - $2,000 Sign-On Bonus Working with technologically advanced CNC machine tools up to 5 axis and creating compl...
  • 4/19/2024 12:00:00 AM

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Lathe Machinist
  • Kimberly-clark
  • Greenville, WI
  • Machinist - $2,000 Sign-On Bonus Working with technologically advanced CNC machine tools up to 5 axis and creating compl...
  • 4/19/2024 12:00:00 AM

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Store Manager - Assistant
  • Stein Garden Centers, Inc.
  • Kimberly, WI
  • Job Description Job Description Position: Assistant Store Manager Reports to: Store Manager Location: Kimberly, WI Type:...
  • 4/18/2024 12:00:00 AM

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Care Manager - Appleton (Hybrid)
  • Lakeland Care, Inc.
  • Appleton, WI
  • Job Type Full-time Description Culture Highlights! Telework environment - work where it's most convenient, home, office,...
  • 4/18/2024 12:00:00 AM

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Store Manager - Assistant
  • Stein Garden Centers, Inc.
  • Appleton, WI
  • Job Description Job Description Position: Assistant Store Manager Reports to: Store Manager Location: Appleton, WI Type:...
  • 4/18/2024 12:00:00 AM

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Store Manager - Assistant
  • Stein Garden Centers, Inc.
  • Appleton, WI
  • Job Description Job Description Position: Assistant Store Manager Reports to: Store Manager Location: Appleton, WI Type:...
  • 4/18/2024 12:00:00 AM

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WORKERS COMPENSATION MANAGER
  • Hiring Now!
  • Green Bay, WI
  • About Us:JBS USA is a leading global provider of diversified, high-quality food products, including a portfolio of well-...
  • 4/17/2024 12:00:00 AM

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Environmental Health and Safety Manager Arrowhead Systems, Inc. Oshkosh, WI Arrowhead Systems, Inc. Oshkosh, WI Posted 1 day ago
  • bioindustrywi.com
  • Oshkosh, WI
  • Number of hires for this role 1 **Qualifications** + Bachelor's (Preferred) + EHS: 3 years (Preferred) + US work authori...
  • 4/17/2024 12:00:00 AM

Appleton is a city in Outagamie (mostly), Calumet, and Winnebago counties in the U.S. state of Wisconsin. One of the Fox Cities, it is situated on the Fox River, 30 miles (48 km) southwest of Green Bay and 100 miles (160 km) north of Milwaukee. Appleton is the county seat of Outagamie County. The population was 72,623 at the 2010 census. Of this, 60,045 were in Outagamie County, 11,088 in Calumet County, and 1,490 in Winnebago County. Appleton is the principal city of the Appleton, Wisconsin Metropolitan Statistical Area, which is included in the Appleton-Oshkosh-Neenah, Wisconsin Combined Sta...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Workers' Compensation Claims Manager jobs
$82,707 to $106,843
Appleton, Wisconsin area prices
were up 1.3% from a year ago

Workers' Compensation Claims Manager in Rockford, IL
The title of Nurse Case Manager is the most frequently used name for the role, but like workers’ comp adjusters are sometimes referred to as claim examiners, there are other names for the NCM. In some insurance companies the role is referred to as the “workers compensation case manager” or “injury management facilitator” or “field case manager” (FCM) if most of the work is done away from the office, or “telephonic case manager” (TCM) if the work is done in the office by using the telephone.
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Workers' Compensation Claims Manager in Mcallen, TX
The Division contracts with a third-party administrator for the processing of state employees’ workers’ compensation claims through a managed-care framework that includes a provider network and pharmacy management. The Division’s staff monitors the work done by the administrator and acts as a liaison between state employees, the third party administrator, and medical providers.
February 08, 2020
Workers' Compensation Claims Manager in Salt Lake City, UT
Some employers will have workers fill out an incident report, while others will be satisfied with just a simple written or emailed notification.
January 27, 2020