Workers' Compensation Claims Manager jobs in Grand Rapids, MI

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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Senior Claims Adjuster - Workers Compensation - Remote, Michigan Residency Required
  • PMA COMPANIES
  • Grand Rapids, MI FULL_TIME
  • As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.

     

    Responsibilities:

    • Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature.
    • Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable).
    • Alert Supervisor and Special Investigations Unit to potentially suspect claims.
    • Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
    • Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure.
    • Negotiate claims settlements with client approval.
    • Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.
    • Work collaboratively with PMA nurse professionals to develop and execute return to work strategies.
    • Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome.
    • Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced.
    • Demonstrate technical proficiency through timely, consistent execution of best claim practices.
    • Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues.
    • Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions.
    • Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department.
    • Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.
    • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
  • 8 Days Ago

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Senior Claims Adjuster - Workers Compensation - Remote, Michigan Residency Requi
  • PMA Companies
  • Grand Rapids, MI FULL_TIME
  • As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropria...
  • 9 Days Ago

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Director Workers Compensation Business, Mary Free Bed Insurance Company
  • Mary Free Bed Rehabilitation Hospital
  • Grand Rapids, MI OTHER
  • Summary: This role is responsible for growing and optimizing a portfolio of existing clinical workers compensation programs and a maturing clinical-captive insurance risk taking “start-up” venture tha...
  • 5 Days Ago

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Director Workers Compensation Business, Mary Free Bed Insurance Company
  • Mary Free Bed Rehabilitation
  • Grand Rapids, MI FULL_TIME
  • Summary: This role is responsible for growing and optimizing a portfolio of existing clinical workers compensation programs and a maturing clinical-captive insurance risk taking "start-up" venture tha...
  • 10 Days Ago

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Compensation & Benefits Manager
  • ArtiFlex Manufacturing
  • Grand Rapids, MI FULL_TIME
  • Compensation and Benefits Manager Seeking an individual experienced with managing Compensation and Benefits for our growing team! In this role, you will oversee and manage all aspects of payroll proce...
  • 7 Days Ago

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Field Technician
  • Hancock Claims Consultants
  • Grand Rapids, MI CONTRACTOR
  • CLIMB to New Heights… And live the_ American Dream. _Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carri...
  • 4 Days Ago

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0 Workers' Compensation Claims Manager jobs found in Grand Rapids, MI area

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Bilingual Human Resources Generalist
  • Pridgeon & Clay
  • Grand Rapids, MI
  • Are you looking for a challenging yet rewarding job that allows you to utilize your skills to their fullest potential? D...
  • 3/28/2024 12:00:00 AM

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Human Resources Assistant
  • Tramec LLC
  • Muskegon, MI
  • Job Description Job Description Description: Come join a growing company that has seen double digit growth over the past...
  • 3/28/2024 12:00:00 AM

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Home Health RN Clinical Manager
  • Humana
  • Grand Rapids, MI
  • Become a part of our caring community and help us put health first CenterWell Home Health serves over 85,000 patients ea...
  • 3/28/2024 12:00:00 AM

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Human Resources Assistant
  • Tramec LLC
  • Grand Rapids, MI
  • Job Description Job Description Description: Come join a growing company that has seen double digit growth over the past...
  • 3/27/2024 12:00:00 AM

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Shift Lead - Floating Overnight Closer
  • Planet Fitness Inc.
  • Grand Rapids, MI
  • Job Summary JP Management Services, LLC is a multi-location Planet Fitness franchisee with nine locations in west Michig...
  • 3/26/2024 12:00:00 AM

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Environmental Health and Safety Manager
  • Van Andel Institute
  • Grand Rapids, MI
  • Van Andel Institute (VAI), a world-class biomedical research institute, located in Grand Rapids, MI, is dedicated to imp...
  • 3/26/2024 12:00:00 AM

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Human Resources Director
  • Workbox Staffing
  • Grand Rapids, MI
  • Company Overview Workbox Staffing is an independently owned and operated staffing agency located in Grand Rapids, MI. We...
  • 3/25/2024 12:00:00 AM

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Overnight Caregiver
  • HCAOA
  • Grand Rapids, MI
  • Our mission at Leaves Personal Care is To Honor God by Serving ALL people with Personalized Care and we want you to be a...
  • 3/25/2024 12:00:00 AM

Grand Rapids is the second-largest city in Michigan, and the largest city in West Michigan. It is on the Grand River about 30 miles (48 km) east of Lake Michigan. As of the 2010 census, the city population was 188,040. In 2010, the Grand Rapids metropolitan area had a population of 1,005,648, and the combined statistical area of Grand Rapids-Muskegon-Holland had a population of 1,321,557. Grand Rapids is the county seat of Kent County. A historic furniture-manufacturing center, Grand Rapids is home to five of the world's leading office furniture companies, and is nicknamed Furniture City. Its ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Workers' Compensation Claims Manager jobs
$82,602 to $106,703
Grand Rapids, Michigan 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.
December 07, 2019
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