This job can be filled in any of our California Branches
Under general supervision, responsible for the supervision and claims management of a claims unit. Provides technical guidance and training to personnel. Evaluates standards of performance of technical and clerical direct reports relative to branch/corporate objectives.
Responsibilities
The essential functions of this position include, but are not limited to, the following
Directs, controls, monitors and provides technical and supervisory guidance to the assigned claims unit(s).
Evaluates performance according to established, Zenith’s standards of performance. Prepares performance appraisals and recommends salary action for staff in unit in accordance with company policy.
Participates in interview and hiring process and trains new employees assigned to unit.
Responsible for claims management of cases assigned to unit, which may include special accounts, within the guidelines of published performance standards, company claim policy and regulatory requirements.
Analyzes claims, sets reserves, determines liability, pays benefits and settles claims within designated dollar authority level and according to company policy and regulatory requirements.
Makes timely investigation assignments and rehabilitation referrals including early return to work programs. Assigns cases to SIU as appropriate.
Maximizes utilization of company medical cost containment programs.
Prepares cases in litigation adequately and appropriately for MSCs and trials.
Communicates with policyholders, injured workers and others in a professional and timely manner.
May assist in preparation of agent status reports and policyholder claim reviews. May be assigned as account coordinator to large policyholders.
Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
Works productively and harmoniously with others on a consistence basis.
Respond positively to direction and criticism of performance.
Consistently maintain professional and appropriate demeanor.
Perform other duties as assigned.
Qualifications
Education, Skills and Experience Requirements
Bachelors degree or equivalent combination of training/experience required.
Minimum (6) years experience handling workers' compensation indemnity claims; to include settlement negotiation of litigated claims required.
Must demonstrate supervisory potential; previous experience or education acquired through seminars and classes preferred.
Advanced knowledge of regulatory requirements and prevailing case law required.
Excellent verbal and written communication skills necessary. PC literacy required.
Good time management, organizational and negotiation skills a must.
Meets all state regulatory standards regarding licensing, continuing education, and other requirements.
Attendance Requirements
Due to the nature of the needs in the office, must be able to work at least 37.5 hours per week, Monday through Friday, and be available should a situation arise requiring extended hours.
Physical, Mental & Sensory Requirements
Designated
Special
Designated
Function
Yes/No
Requirements
Yes/No
Function
Degree
Sitting
Yes
Hand Manipulation
Yes
Mathematics
High
Walking
Reaching
Yes
Reading
High
Standing
Grasping
Yes
Verbal
High
Bending
Visual
Yes
Written
High
Kneeling
Auditory
Yes
Reasoning
High
Lifting
Driving
May
The above statements are intended to describe the general nature and level of work performed. They are not intended to be an exhaustive or exclusive list of the required responsibilities, duties and skills. Management retains the discretion to add to or change the duties and requirements of this position at any time as needs dictate.
Zenith Insurance Company - 30+ days ago
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