Position Summary:
National OnDemand, Inc. is a communications and utilities infrastructure provider delivering service solutions to the Fiber, Wireless, Energy and Technology sectors in the United States. Headquartered in Burlington, North Carolina, the Company provides full turnkey infrastructure solutions – on demand, anywhere across its service footprint and has secured and sustained its current standing in the market through the successful completion of mergers and acquisitions, along with demonstrable, steady organic growth.
The Risk Claim Specialist responsiblities are to coordinate and administer workers’ compensation program and property and casualty claims.
Primary Position Duties:
- Process and document all worker’s compensation claims and property & casualty claims, ensuring compliance with relevant policies, procedures, and legislation.
- Serve as liaison with external agencies and regulatory bodies in the claims administration and the care and disposition of claimants.
- In coordination with the Director of EHS & Risk, evaluate property and casualty claims to determine liability, damage and exposure.
- Assist the Director of EHS & Risk, Legal, in third-party claims, including negotiations and settlement.
- Reviews and evaluates all work-related accident reports for completeness and clarity of data analyzes data, as needed, to ensure compliance with policy and regulatory requirements.
- Determines appropriateness and amount of worker’s compensation claims investigates individual claims for eligibility for workers’ compensation benefits ensures that all legal and procedural requirements are met for the processing of claims to ensure proper and timely payment to employees and medical facilities.
- Provide authoritative advice and counsel to organizational leadership on interpreting and applying for worker’s compensation and property & casualty policies, legislation, regulations, and processes.
- Liaison with the organization’s insurance broker and providers.
- Coordinates and participates in strategic planning aimed at reducing the incidence of worker’s compensation-related injuries.
- Assembles appropriate medical information and facts regarding claims for cases pending litigation participates in the Workers’ Compensation Administration mediation and formal hearings.
- Communicates and interacts with medical professionals, support agencies and others to monitor and assess the progress of rehabilitation efforts and to facilitate either return to work, job restrictions or, depending upon the medical status of the claimant, placement into appropriate alternative positions, ensuring compliance with all appropriate regulations and guidelines.
- Updates organizational leadership on employees’ return to full duty status.
- Prepares all necessary forms, records and documentation, including statistical analyses and reports, for all claims, as required by various regulatory agencies.
- Makes recommendations for reducing the frequency and severity of losses using a workers’ compensation database and/or other claims data reports designs and develops databases performs integrated data analyses and prepares reports.
- Process assigned property and casualty claims and performed other job-related duties as assigned.
- Claims support during Emergency Events.
- Assist EHS & Compliance Administrator as needed.
- Assists the Director of EHS & Risk in developing policies and procedures to reduce risk.Performs miscellaneous job-related duties as assigned.
Position Requirements:
- Access-only office environment with reasonable heating and cooling.
- The position will be at a computer workstation much of the time.
- Ability to work extended or irregular hours/days (nights and weekends)
- Prolonged sitting at a computer workstation performing repetitive tasks.
- Ability to occasionally lift, push, or pull up to 25 lbs.
- Must have reliable transportation and a valid driver’s license.
- Ability to travel 10% of the time.
Education or Skills:
- Bachelor’s Degree in Business Administration at least four years of directly related experience in claims adjusting, investigations, litigation and/or risk management.
- One or more certifications – Certified Medical Insurance Specialist (CMIS), Certified Billing & Coding Specialist (CBCS), Associate in Claims (AIC), or Associate in General Insurance (AINS).
- 4 years of experience in risk management handling various claims processes.Ability to liaison with insurance carriers professionally.
- Ability to work independently or with a team at all levels of the organization.
- Ability to maintain confidentiality.
- Ability to professionally represent the organization.
