Job Details

You must submit a cover letter and resume to be considered for this position. If you have previously submitted a profile to Dart, you must edit your profile and add an updated cover letter and resume.

 This position is responsible for managing Dart's multi-state workers' compensation program, including ensuring compliance with all federal and state laws. The program consists of six self-insured states (MI, IL, PA, KY, MS, NC) where the claims are self-administered in-house.  All other states are insured with claims managed by a third party administrator.   

 Specific Duties:

 Manage all aspects of the workers' compensation claim program for the reporting and administration of claims, employing technology to the fullest extent possible.

• Understand and be able to manage all aspects of the claim process, including (1) determining benefits due to the employee; (2) establishing and maintaining accurate reserves and related financial information; (3) completing and submitting all required state filings; (4) documenting all work activity in claims software system to maintain paperless files; (5) establishing and maintaining electronic diaries for timely follow up of claim activities; (6) managing claimant's medical treatment, recovery and return to work, including appropriate referrals for nurse case management or investigative services; (7) managing litigated claims according to company practices and procedures; and (8) negotiating and resolving claims equitably, obtaining appropriate documentation.

• Perform quality assurance reviews of current claims to ensure compliance by adjusters with all program processes and procedures. Create and implement action plans with adjusters to improve claim handling and better position claims for resolution. Measure, monitor and ensure accuracy of claim data, customer service expectations and regulatory requirements.

• Develop and implement vendor service arrangements to assist with the cost containment of medical, indemnity and expense costs; ensure timely delivery of services to customers; and ensure program compliance with statutory and regulatory requirements for each state serviced (ex: attorney firms, investigation companies, prescription benefit managers, nurse case managers, vocational rehabilition services, etc.). Monitor and drive appropriate utilization of contracted vendors to ensure claimants receive timely and appropriate services at appropriate costs.

• Maintain high-level contact with the plants, departments, safety and human resources. Support and assist on workers compensation related requests or requests that may overlap a workers compensation matter. Prepare status reports, present cases and participate in claim review meetings as needed. 

• Work with Risk Management Analysts on analysis of claims data for appropriate reporting such as, lag time, incurred reserve changes, open claim inventory, identification of trends, etc. Conduct strategic planning to identify and implement appropriate recommendations to prevent and mitigate losses.  Develop, implement and monitor the effect of cost containment programs.

• Comprehend and apply multiple state laws and procedures as applicable to the management of claims.  Maintain current knowledge of applicable laws, rules, and regulations.  Evaluate the impact of current, proposed, and/or new laws, rules, regulations and issues.  Monitor the progress of court cases, proposed legislation, rules, and regulations.  Develop, implement, manage and direct processes and procedures to ensure compliance with new laws, rules and regulations. 

• Manage claims adjusters, including performance management, salary planning and administration, training and development, workflow planning, hiring and placement and disciplinary actions.  Create a working environment that fosters a high level of technical competency and opportunity for development and growth.

• Work with Risk Management leadership in developing comprehensive, streamlined guidelines, training materials and procedures for handling claims.

• Participate in all professional conferences, claims and management training (both internal and external) and professional development courses to stay up to date on current workers' compensation industry and individual state specific processes and regulations.