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State Fund Claims

Workers' Compensation Claims Representative - State Fund - Cincinnati, OH & Dublin, OH

Basic Function

Responsible for all phases of client workers’ compensation programs including aggressive claims management, general administration, and client relations. The Account Executive position requires special focus on client risk management strategies and exceptional customer service.

Responsibilities

  • Utilize experience to serve large, more complex Clients.
  • Aggressively manage all Active claims.
  • Aggressively implement strategies for return-to-work on all Lost-time claims.
  • Aggressively manage appropriateness of medical treatment & costs on all claims.
  • Pursue risk strategies to control and/or lower claims costs that impact a client’s experience modification e.g. handicap reimbursements, lump sum settlement, fraud recognition, etc.
  • Provide consultative assistance to clients regarding rating plans e.g. Group rating, Self-insurance, Retrospective rating, etc.
  • Assist and advise client on BWC employer discount programs, payroll classification and reporting information.
  • Meet regularly with client to perform a complete claims review, review employer modification, and develop risk strategies to control or reduce future premiums.
  • Create and provide claims management reports to client e.g. claims costs, employer rate projection, claims loss runs, etc.
  • Provide timely updates to employer on workers’ compensation laws and rules.
  • Perform other related duties as assigned.

Experience

Prefer 3 plus years of workers’ compensation claims management or related experience. State fund claims management experience required.

TPA and/or MCO exposure desired. 

Skills

  • Strong Written and Oral Communication Skills
  • Client Service/Client Relations
  • Claims Management
  • Organized and Detail Oriented
  • Workers Compensation Knowledge
  • Employer Risk Knowledge