TMD Staffing is looking to hire a Claims Administrator for an internal opportunity!

Join our Corporate Team! Apply Today!

GENERAL PURPOSE

Analyzes and reviews claims for accuracy, completeness, and eligibility. Prepares and maintains

reports and records for processing.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Manage TMD s efforts to comply with state and federal laws relative to Workers Compensation claims.
• Demonstrate a working knowledge of the various state workers compensation laws / requirements / procedures.
• Demonstrate a working knowledge of federal and state requirements, OSHA, ADA,
• EEOC and other mandates as applicable to the staffing industry.
• Verify all required safety notices/posters are displayed at all locations
• Comply with company policies and procedures
• Identifies exposures to the company and reports to senior-level management on pending claims and litigation that may have an adverse impact on the corporate goals.
• Responsible for viewing monthly webinars through TRIAD
• Provide oversight in the administration of all workers compensation claims to achieve minimal lost time through effective modified duty programs and physician/clinic relationships.
• Monitor the Return to Work / Modified Duty Program to provide accommodating modified duty for all injured employees upon receipt of a doctor s release for modified duty.
• Assist in the development of modified duty assignments that encourage the injured employees to return to regular work duties.
• Oversee the compliance aspects of return to work / modified duty programs related to individual state policies.
• Assist in getting injured employee to work at client facility
• Reviews and analyzes claims loss and expense reserves established by insurance carriers.
• Processes new claims and disseminates the claims to the appropriate adjuster.
• Acts as liaison between corporate and field offices to facilitate the gathering of information that will allow proper response to claim losses and legal documents.
• Reviews injury/illness and non-injury incident investigation reports and follows up as necessary.
• Monitors lost-time injuries/illnesses and worker s compensation claims.
• Examine, process, calculate and pay claims insuring filings, documentation and reports, etc.
• Assist claimants, providers and clients with problems or questions regarding their claims and/or policies.
• Enter codes and verify data for computer processing.
• Prepare and review medical bills for payment of claims and verify that medical reports have been processed accordingly.
• Oversee scheduling and TMD s designated participant in claim reviews with third party administrators at least semi-annually (or as required).
• Monitor issues including timeliness of reporting both at the branch and corporate levels, open claim status, and effective use of second injury funds where applicable.
• Maintain an accident / injury log and oversee distribution to the branches to facilitate a working knowledge of accident / injuries and to help identify trends, frequency, and types of accidents.
• Acts as liaison between the insurance carriers and insurance broker to maintain loss
• expense reserves that are reflective of the company s exposure.
• Acts as the liaison to attorneys, insurance companies and individuals investigating any
• incidents that may result in asset loss.
• Performs other duties as assigned.
  

DESIRED MINIMUM QUALIFICATIONS

Graduation from high school or GED equivalent with 2 or more years of related experience and/or training.

Apply Online or email your resume to rdennis@texasmgmt.com for immediate consideration.

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