Workers Compensation Administrator jobs in Vineland, NJ

Workers Compensation Administrator II administers the workers' compensation program for an organization. Implements a consistent process for recording, investigating, and reporting workers' compensation claims complying with laws and regulations. Being a Workers Compensation Administrator II prepares and submits required reporting and documentation to OSHA, state and local agencies, and other entities. Monitors all claims and liaises with the employees, managers, insurance representatives, union representatives, medical staff, and attorneys involved with a case. Additionally, Workers Compensation Administrator II communicates case status details and necessary information to involved parties, including notifications of hearings, outcomes, return to work, or restrictions. Performs periodic reviews of overall cases to identify trends. Maintains up-to-date knowledge of all regulations and laws for reporting workers' compensation. May coordinate or assist with safety programs focused on injury prevention or facilitate accommodations for workers. May require a bachelor's degree. Typically reports to a manager. The Workers Compensation Administrator II occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Workers Compensation Administrator II typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Regional Claims Specialist (Workers' Compensation Claims)
  • NJM Insurance
  • Hammonton, NJ FULL_TIME
  • Introduction

    Personal, compassionate service is what we’re known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy some of the best benefits in the industry, you'll also be joining a company that's committed to professional development, diversity and innovative thinking.

    What is it like to work at NJM?  Click here to see!

    If you don't see the position you are looking for, apply here.

    Overview

    NJM’s Workers’ Compensation Claims Team is seeking a Regional Claims Specialist. This is a full-time position and offers a hybrid schedule after training.

    The Regional Claims Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim, and outlining and recommending an action plan to manage the claim. The Regional Claim Specialist will work with and communicate to all internal and external stakeholders, including: NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, the NJM Special Investigation Unit, WC Legal Staff, and other departments within NJM, as well as outside defense counsel and vendors.

    This role can be based in NJM’s West Trenton, NJ or Hammonton, NJ office location.

    Responsibilities

    • Execute strategic and operational goals and objectives of the WCC department and company business goals, guidelines, and programs.
    • Recommend process improvement where applicable to best improve the department efficiency, work product, and service commitment to interested parties.
    • Manage litigated claims through proactive execution of action plans to resolve claim issues to move cases toward closure and reduce aged inventory.
    • Ensure quality management of claims in accordance with claims best practices and company guidelines, and timely, accurate documentation of claim activity.
    • Provide a high level of customer service that promotes injured worker advocacy-based principles to maximize return to work motivation and improve outcomes for all parties. 
    • Determine compensability and coverage issues that have been placed in litigation by gathering medical and factual evidence.
    • Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits.
    • Evaluate the claim for potential fraud indicators and escalate the file to SIU, as appropriate.
    • Recognize and investigate subrogation opportunities for recovery of third-party funds.
    • Initiate and provide excellent communication with all stakeholders (injured workers, providers, attorneys, brokers, clients, etc.) professionally and proactively with a customer-centric approach.
    • Apply critical thinking skills to evaluate and mitigate exposures, and establish and implement a proactive strategic plan of action.
    • Assign and refer claim petitions to Counsel, and work to resolve the claim within given authority.
    • Promptly manage and resolve issues on litigated cases, inclusive of evaluating claim exposure, negotiating, and resolving claims.
    • Build rapport with the policyholder, conduct on-site investigations when necessary, and educate the policyholder on NJM legal procedures, policies, and claim practices.
    • Prepare for Claim Reviews; attend and participate as needed with the Claims Team and Supervisor.
    • Participate in in-house and outside training programs to keep current on relevant issues/topics.
    • Demonstrate a commitment to NJM’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work.

    Requirements

    • Level I- 0-3 years’ experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including basic knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
    • Level II- 3-5 years’ experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
    • Sr Level– 5 years’ experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including advanced knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
    • Knowledge of WC regulations and jurisdiction(s) to be able to formulate a Plan of Action to bring claims to resolution.
    • Knowledge of and experience working Work with liens and Medicare Set-Asides to secure full and final settlements.
    • Customer service oriented with strong written and oral communication skills.
    • Strong interpersonal skills with ability to work both in a team and independently.
    • Demonstrated organizational skills, and use of sound decision-making capabilities.
    • Working knowledge utilizing an automated claim processing system and the Microsoft Office suite of tools (Word, Excel).
    • Ability to travel for business purposes, approximately less than 10%.

     

    Preferred:

    • Multi-state experience and/or licensing (including NJ, MD, CT, DE, PA and/or NY).
    • Associate or Bachelor’s degree.
    • AIC/CPCU Designations.

     

    Salary:

    • Level I - $54K - $68K annually based on experience and credentials.
    • Level II - $62K annually based on experience and credentials.
    • Sr Level - $75K annually based on experience and credentials.


    Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
  • 19 Days Ago

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Claim Account Specialist (Workers' Compensation Claims) - Hammonton, NJ
  • NJM Insurance Group
  • Hammonton, NJ FULL_TIME
  • NJM’s Workers’ Compensation Claims Team is seeking two Claim Account Specialists. This is a full-time position and offers a hybrid schedule after training. The Claims Account Specialist will be respon...
  • 6 Days Ago

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Complex Claim Specialist (Workers' Compensation Claims) – Hammonton or West Tren
  • NJM Insurance
  • Hammonton, NJ FULL_TIME
  • IntroductionPersonal, compassionate service is what we’re known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy ...
  • 1 Month Ago

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Food Service Workers
  • Maschio's Food Service
  • Pittsgrove, NJ PART_TIME
  • School Food Service Workers needed in the Pittsgrove, NJ area . Monday through Friday, part time 4-6 hours daily. Food service experience a plus but not necessary, we will train. No weekends or holida...
  • Just Posted

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Food Service Workers and Substitutes
  • Hamilton Township School District
  • Mays Landing, NJ PART_TIME
  • Responsibilities:- Prepare and serve food and beverages to customers- Ensure that food and beverage areas are clean and well-stocked- Maintain cleanliness and sanitation standards in accordance with h...
  • 27 Days Ago

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Food Service Workers needed for School Food Service
  • Maschio's Food Service
  • Pittsgrove, NJ FULL_TIME
  • School Food Service Workers needed in the Pittsgrove, NJ area . Monday through Friday, part time 4-6 hours daily. Food service experience a plus but not necessary, we will train. No weekends or holida...
  • Just Posted

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0 Workers Compensation Administrator jobs found in Vineland, NJ area

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Vice President, Division of Human Resources
  • University Of Pennsylvania
  • Wilmington, DE
  • Vice President, Division of Human Resources page is loaded Vice President, Division of Human Resources Apply locations F...
  • 4/24/2024 12:00:00 AM

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Talent Acquisition Specialist
  • KYYBA
  • Wilmington, DE
  • Job Description Job Description Qualifications: To be considered for this position, you must possess the following: • Ba...
  • 4/24/2024 12:00:00 AM

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Human Resources Manager
  • Craig Bradford Associates
  • Thorofare, NJ
  • Salary: $90,000 - $110,000 (depending upon experience) The Human Resources Manager is responsible for guiding and direct...
  • 4/22/2024 12:00:00 AM

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Senior Compensation Analyst
  • GQR
  • Wilmington, DE
  • Position Summary: As a Senior Compensation Analyst/Compensation Business Partner , you will play a pivotal role in desig...
  • 4/22/2024 12:00:00 AM

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HR Manager
  • US Foods, Inc.
  • Perth Amboy, NJ
  • ESSENTIAL DUTIES AND RESPONSIBILITIES Ensure a genuine safety culture that fosters employee well-being through engagemen...
  • 4/20/2024 12:00:00 AM

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Human Resources Manager
  • Craig Bradford Associates
  • Thorofare, NJ
  • Salary: $90,000 - $110,000 (depending upon experience) The Human Resources Manager is responsible for guiding and direct...
  • 4/20/2024 12:00:00 AM

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Compensation Analyst
  • Chesapeake Utilities Corporation
  • Newark, DE
  • Chesapeake Utilities Corporation Career Opportunity Compensation Analyst Location: Remote within service area states of ...
  • 4/20/2024 12:00:00 AM

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Human Resource Project Manager (Hybrid)
  • Quad A Solomonedwards Company
  • Wilmington, DE
  • Human Resource Project Manager (Hybrid) Responsibilities of the Human Resource Project Manager Reporting to the M&A Prog...
  • 4/20/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 69.029 square miles (178.785 km2), including 68.424 square miles (177.218 km2) of land and 0.605 square miles (1.568 km2) of water (0.88%). Of all the municipalities in New Jersey to hold the label of City, Vineland is the largest in total area. (Hamilton Township in Atlantic County is the largest municipality in New Jersey in terms of land area. Galloway Township, also in Atlantic County, is the largest municipality in total area, including open water within its borders.) Vineland borders Deerfield Township, Millville,...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Workers Compensation Administrator jobs
$71,257 to $97,245
Vineland, New Jersey area prices
were up 1.5% from a year ago

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