Stanford Health Care

Heal Humanity Together

Claims Manager – Workers Compensation

ManagerManagerFull TimeRemoteTeam 10,001+Since 1991H1B SponsorCompany SiteLinkedIn

Location

California

Posted

111 days ago

Salary

$66 - $88 / hour

Bachelor Degree5 yrs expEnglish

Job Description

• Responsible for oversight of all TPA activities to ensure efficient and cost-effective claims handling in accordance with hospital policies and procedures and the applicable service agreement. • Review reserves, settlement activity, and claims costs. • Participate in periodic claim reviews and provide substantive input regarding claim strategy. • Participate in negotiation of TPA contracts. • Serve as liaison with external departments, including Human Resources, Workforce Health and Wellness, and Environmental Health & Safety to coordinate issues impacting claim resolution and injury/illness prevention. • Participate in periodic committee meetings as warranted. • Provide training related to claims workflow and processes. • Responsible for collection and analysis of claims data. • Create reports and disseminate claims data to stakeholders. • Evaluate trends to support loss prevention. • Ensure timely and accurate processing of all claim invoices.

Job Requirements

  • Bachelor’s degree in a work-related field/discipline from an accredited college or university.
  • Minimum five (5) years of progressively responsible and directly-related work experience.
  • Claims Practitioner in Workers’ Compensation (CPWC) certification preferred.
  • Ability to analyze and develop solutions to complex problems.
  • Ability to apply judgment and informed decisions.
  • Ability to communicate effectively in written and verbal formats including summarizing data and presenting results.
  • Ability to establish and maintain effective working relationships.
  • Ability to work effectively both as a team player and leader.
  • Knowledge of computer systems and software used in functional area.
  • Knowledge of local, state and federal regulatory requirement related to the functional area.
  • Knowledge of medical terms, concepts and practice.

Benefits

  • SHC Commitment to Providing an Exceptional Patient & Family Experience
  • C-I-CARE standards for all patients and families
  • Equal Opportunity Employer

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