Claims Consultant

Job Details

Job Location
Remote with travel to Seattle - Seattle, WA

Claims Consultant

Take the Lead in Making a Real Impact. Join Archbright as a Workers' Compensation Claims Consultant

Are you an experienced workers' compensation professional with a passion for proactive case management and meaningful employer engagement? Archbright, a trusted name in workplace performance and compliance, is looking for a Workers' Compensation Claims Consultant to join our dedicated team. You'll be part of an organization that values grit, inclusion, fun, transformation, engagement, and delivery-our GIFTED values.

Position Summary-

Works as part of a team that provides Workers' Compensation Claims Management services to employers in a Retrospective Rating Program environment. Manages claims of all complexities including complex and catastrophic claims by communicating with employers, medical providers and Washington State's Department of Labor and Industries. Works proactively to accelerate claims closure and mitigate financial exposure

Qualifications

Essential Responsibilities and Duties:

• References and follows Archbright's claims management best practices and Gardiant policy as documented and makes suggestions for improvement.
• Educates employers about retrospective rating programs and/or ReClaim and requirements of the appropriate Archbright agreement.
• Corresponds with medical specialists, employers, state adjudicators, and vocational counselors to compile information and documentation.
• Investigates, analyzes, and determines insurance liability concerning worker's compensation injury claims in accordance with state law. Coordinates with Archbright HR Advisors and Attorneys as needed.
• Develops proactive plans of action for each claim and provides timely updates to the employers.
• Works to accelerate claim closure and documents plans of action.
• Verifies benefit payments and orders for accuracy and eligibility as well as Kept on Salary, (KOS) as needed.
• Advises and assists the employer of appropriate implementation and management of formal job offers and return-to-work programs in accordance with state regulations. Documents recommendations and plan of action.
• Manages and monitors Retro compliance as appropriate and takes required actions.
• Conducts freeze reviews and creates and implements strategies to maximize claim closures and minimize costs for the employer and retro program.
• Educates employers about L&I's Stay at Work and Preferred Worker reimbursement programs and works to ensure employers submit in a timely manner.
• Develops a productive working relationship with assigned member accounts and provides excellent customer service while following the requirements outlined in the Claims customer services guidebook.
• Prepares for and represents Archbright in Board of Industrial Appeals process. Consults with Supervisors as needed.
• Identifies and refers appropriate cases to the Claims Supervisor for intervention, legal review and/or litigation preparation.
• Collaborate with Loss Control to strategize the best financial outcome for an employer.
• Other duties, responsibilities, and activities may change or be assigned at any time with or without notice.

Additional Responsibilities:

• Prepare and conduct open claim reviews with members as requested or as needed.

Essential Qualifications for the Role:

• Ability to prioritize with accuracy in a fast-paced environment
• Ability to follow department practices and procedures and make suggestions for improvement.
• Ability to write clear and grammatically correct emails and claims reviews/plans of actions.
• Ability to provide high quality, accurate and timely service to members.
• Ability to identify when a question or issue requires legal advice.

Other Archbright Qualifications and Duties :

Qualifications:

• Excellent written and verbal communication skills for both internal and external audiences.
• Proficiency in working independently and as part of a team.
• Ability to hold oneself and others accountable to expectations and due dates.
• High tolerance for change, with an openness to organizational change, continuous improvement, and a willingness to learn new skills.
• Ability to provide regular and consistent attendance.

Duties:

• Participate in Archbright connection and communication experiences including creating and working on quarterly objectives, 1:1s with manager, weekly check-in, and team, department, and company meetings.

Demonstrate Archbright GIFTED Values (Grit, Inclusion, Fun, Transform, Engage, and Deliver) and support IDEAL principles (Inclusion, Diversity, Equity, Accessibility, and Leadership.)

Position Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Supervisory Responsibilities: None but does serve in a lead capacity.

Education and Experience:

• Required: High school diploma or equivalent required
• Required: 3 or more years managing workers' compensation claims
• Preferred: Experience managing claims in a retrospective rating environment.

Certificates, Licenses, or Registrations:

• Required: NA
• Preferred: WA State certification or WWCP designation.

Technical Skills:

• Required: Excellent MS Office Suite experience, particularly Outlook, Word, Excel
• Preferred: Experience with claims management systems, SharePoint, and current office automation tools

Physical Demands:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

The employee may need to spend extended periods of time using a computer, as well as participating in phone calls and video conferences.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

While performing the duties of this job, the employee is regularly exposed to computer monitors and shared workspaces, if/when required to work from a shared office space.

The complete salary range for this position is$73,841 to $103,368 with ahiring range of$79,744 to $88,604. Archbright Keystone is our Total Rewards program for our most valuable assets - our people. These benefits have been carefully chosen and put in place because together they support the harmony of work and life. They include generous front-loaded Paid Time off (PTO), 11 paid holidays, subsidized medical, dental and vision benefits, hybrid and remote work (dependent on position and member need/timing), 401K with employer match, short- and long-term disability, life insurance, employee assistance programs and more!

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Archbright believes that each employee makes a significant contribution to our success. That contribution should not be limited by the assigned responsibilities. This position description is designed to outline primary duties, qualifications, and job scope, but not limit our employees nor the organization to just the work identified. It is our expectation that each employee will offer his/her services wherever and whenever necessary to ensure the success of the company.