Stanford Health Care
Heal Humanity Together
Claims Manager – Workers Compensation
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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