Responsibilities
CORE RESPONSIBILITIES AND TASKS:
- Strategic Oversight: - Maintain strategic oversight for workers' compensation claims with TPA.
- Evaluate and coordinate information from field regarding special cases or issues.
- Communicate claim issues with adjusters and local HR or EHS managers, as needed.
- Ensure claim management and resources are utilized in accordance with best practices and service instructions.
- Assess claim activity or recommendations for achieving final resolution.
- Financial / Legal Activities: - Reviews and evaluates financial liability established by adjusters to ensure they are timely, appropriate and adequate
- Review large medical and/or expense payments for accuracy and timelines and processed pursuant to service instructions, internal controls or state laws
- Consider key cost drivers, recommendations or modifications to positively impact outcomes
- Partner with TPA and WC HR Analyst to acquire data needed for various state filings, identifying pertinent information and requesting through internal departments to satisfy requirements
- Claim Management: - Ensure the use of appropriate resources and strategic vendor partnerships to reduce overall cost and provide greater efficiencies and improved employee and employer outcomes.
- Facilitate strategic claim discussions and resources to maximize opportunities for claim resolution including leveraging claim settlements,
- Establish return to work opportunities and resolving claim issues, ensuring appropriate state administrative and federal laws, ADA, FMLA, HIPAA, and internal partnerships are considered
- Engage and counsel LOA Team, HR or EHS Managers with recommendations, referencing and applying internal policies, processes, state laws or regulations
- Maintain on-going communication addressing claim resolution, action plan/processing with appropriate HR, EHS, site/store management.
- Establish periodic evaluation of electronic claim files to establish proper documented and claim coding/activity dates are correct based on most recent activity
- Make strategic recommendations to the field for identifying trends or reducing claim frequency and/or severity using appropriate analytical tools
- Workers Compensation Program Development/Communication/Training: - Assist with the WC program content, development, communication, and distribution of materials or posting information with various company electronic sites
- Provide orientation and training to internal and field HR & EHS staff
- Review potential modifications to various internal processes for increased efficiencies, as necessary
- Assess development of integrated system efforts to improve overall management/department efficiency
- Vendor Management: - Oversee third party adjusters to ensure proper claim handling and coordination of benefits
- Schedule and coordinate discussions with interested internal and external resources for solving or improving performance or services
- Identify and advise Manager of trends, problems, and issues as well as recommended course of action; recommend new procedures or ideas for continuous process improvement
- Interact with vendor providers/resources for ensuring and increasing program effectiveness
Qualifications
FORMAL EDUCATION:
Required:
Preferred:
- Bachelors' Degree in Finance, Risk Management, Human Resources
- Professional certifications (Workers Compensation or Disability Management)
KNOWLEDGE & EXPERIENCE:
Required:
- Minimum of 1 year Insurance/Claims Management
Preferred:
- 3-5 years Workers' Compensation or Claims Management
- Non-occupational Disability Management (STD or LTD)
- Finance and/or Risk Management exposure
- Supervision
TECHNICAL/SKILL REQUIREMENTS:
Required:
- Excellent oral and written communication, including presentation skills
- Proficient in Microsoft Office tools including Outlook, Word, Excel, Powerpoint and Sharepoint
- Leadership/management/motivational skills
- Analytical and interpretive skills
- Strong decision-making skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiation skills
- Ability to work a fast-paced environment
- Preferred:
- Thorough knowledge of claims management processes and procedures
- Knowledge of appropriate insurance principles and laws and
- Employee Benefits / Disability Plans / ADA / FMLA / Social Security and Medicare
- Supervision
Travel 10%
About us
Here, we believe there's not one path to success, we believe in careers that grow with you. Whoever you are or wherever you come from in the world, there's a place for you at Sherwin-Williams. We provide you with the opportunity to explore your curiosity and drive us forward. Sherwin-Williams values the unique talents and abilities from all backgrounds and characteristics. All qualified individuals are encouraged to apply, including individuals with disabilities and Protected Veterans. We'll give you the space to share your strengths and we want you show us what you can do. You can innovate, grow and discover in a place where you can thrive and Let Your Colors Show!
At Sherwin-Williams, part of our mission is to help our employees and their families live healthier, save smarter and feel better. This starts with a wide range of world-class benefits designed for you. From retirement to health care, from total well-being to your daily commute-it matters to us. A general description of benefits offered can be found at http://www.myswbenefits.com/ . Click on "Candidates" to view benefit offerings that you may be eligible for if you are hired as a Sherwin-Williams employee.
Compensation decisions are dependent on the facts and circumstances of each case and will impact where actual compensation may fall within the stated wage range. The wage range listed for this role takes into account the wide range of factors considered in making compensation decisions including skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled.
The wage range, other compensation, and benefits information listed is accurate as of the date of this posting. The Company reserves the right to modify this information at any time, with or without notice, subject to applicable law.
Sherwin-Williams is proud to be an Equal Employment Opportunity/Affirmative Action employer committed to an inclusive and diverse workplace. All qualified candidates will receive consideration for employment and will not be discriminated against based on race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, pregnancy, genetic information, creed, marital status or any other consideration prohibited by law or by contract.
As a VEVRAA Federal Contractor, Sherwin-Williams requests state and local employment services delivery systems to provide priority referral of Protected Veterans.
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