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NEOGOV · 1 day ago

Claims Manager - Workers' Compensation

Denver, CO

Full-time

Hybrid

Senior Level

$4,906/mo - $6,800.88/mo

5+ years exp

NEOGOV is part of the State of Colorado's Department of Labor and Employment, which focuses on connecting workers with jobs and ensuring fair labor practices. The Claims Manager for Workers' Compensation will oversee the administration of the Workers’ Compensation Act, providing training, audits, and compliance monitoring for claims handling while assisting various stakeholders in the claims process.

GovTechHuman ResourcesInformation TechnologySoftware

No H1B

Responsibilities

This position is responsible for the hands-on administration of the Workers’ Compensation Act and Rules of Procedure with regard to claims handling

This position provides daily reviews, monetary audits, education, training and information for all parties to claims, plus intervenes in workers’ compensation related matters, as well as other related claims duties assigned

The Claims Managers assist claimants, attorneys, medical providers, and employers in processing their workers’ compensation claims by interpreting and explaining case law, regulations (statutes), and rule procedures, as well as intervening between parties to resolve claim issues before escalating to the hearing process

The position monitors insurance carriers and TPAs to ensure compliance with applicable statutes and rules, and assesses penalties for non-compliance when necessary, as well as educate and train claims representatives on new and old case law, statutes and revised statutes, existing rules and revised rules

This position reviews claim filings from 1983 to present, which includes three (3) statute changes, and multiple rule changes

Qualification

Claims adjustingWorkers' compensation managementRegulatory complianceCase law interpretationTrainingEducationAnalytical skillsCommunication skillsProblem-solving skills

Required

Five (5) years of relevant experience in an occupation related to the work assigned to this position to include: Claims adjusting related work and duties, workers compensation claims management to include form completion and submission, calculating benefit wages, familiarity with the type of benefits, rules and regulations claimant communications

A combination of related education and/or relevant experience in an occupation related to the work assigned equal to five (5) years

Must be a current resident of Colorado

Must pass a thorough background check prior to employment which will include the E-Verify process

Preferred

Experience performing similar duties as a State of Colorado classified employee

1-2 years of experience in claims adjusting: paying out lost wage benefits, authorizing medical treatment, investigating claims for compensability, etc