risk management. we know the territory.

Self Insured Claims Representative

Department/Location

Self Insured

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Job Description

Come be a part of one of the fastest growing and most well-respected risk management companies! We are currently seeking a Workers’ Compensation Self Insured Account Executive in our Cincinnati or Dublin, OH office, to serve as the single point of contact for an assigned client base.

Basic Function

Serve as the single point of contact for assigned Self Insured clients. Responsible for all phases of self insured workers’ compensation program including but not limited to aggressive claims management, general administration, and client relations. The SI Account Executive position requires special focus on risk management strategies and exceptional customer service.

 Responsibilities

  • Assist and advise clients on all aspects of self insured workers’ compensation programs.
  • Provide aggressive claims management for all workers’ compensation claims.
  • Develop aggressive action plans that utilize best practice strategies to improve return-to-work and cost controls.
  • Coordinate referrals to partner entities for investigations, field case mgt, and other cost containment services.
  • Calculate and assign appropriate reserves to claims; monitor reserve adequacy for life of claim.
  • Communication with injured workers, employers, attorneys, and related medical providers.
  • Review all medical treatment requests (C9s), fee bills, and medical records for appropriateness.
  • Process fee bill payments, reductions and denials.
  • Calculate payment of all compensation types, make timely payments, and issue claim/comp checks.
  • Prepare files for hearings of litigated issues.
  • Ensure client self insured program is compliant with all state rules and regulations including filing of all required State forms, reports and data. Assist with and ensure SI-40 reporting (Ohio).
  • Evaluate claim values for settlements and present to client. Negotiate to client approved level.
  • Attend client audits performed by the State.
  • Coordinate filing and reporting of 1099s to IRS.
  • Report, track and manage claims for submission to Excess carrier.
  • Regularly coordinate and attend client meetings for program review, strategies, and claim reserves.

 WHAT’S IN IT FOR YOU?

Matrix offers an excellent compensation and benefits package as well as an exciting, positive work culture.

Preferred Skills

Experience

A minimum of 3 years relevant experience and exposure to Ohio Workers’ Compensation.

Self Insured experience required.

The Matrix Companies is an entrepreneurial organization with unlimited growth potential. If you are passionate about performance, driving the profitability of a growing company and exceeding expectations at all times – Matrix is right for you!

Come join The Matrix Companies team.

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