• Claim Specialist

    Job Locations US-TX-Irving
    Posted Date 5 days ago(10/11/2018 2:21 PM)
    ID
    2018-50448
    Category
    Finance
  • Overview

    A 7-Eleven may bring to mind thoughts of coffee, gas, and slurpees. But we are making some serious moves to digitally transform into a store of the future, exploring e-commerce, augmented reality, and artificial intelligence to meet the changing needs of customers.

     

    For 90 years, 7-Eleven has been successfully meeting customers’ needs. But convenience is now being redefined. We’re integrating more than 66,000 stores worldwide with a strong digital and e-commerce presence. Through machine learning, artificial intelligence and next-level mobile technologies, we’ll meet—and exceed—our customers’ ever-changing needs. Sound like your kind of environment? Read on.

     

    The Claim Specialist is responsible for coordinating and administering the internal functions related to responding to Workers Compensation. This includes claim coordination with employee, doctors and TPA; store operations support; return to work and leave coordination, court decisions and appeal. Leading TPA related to strategy, reserve approvals, nurse case management, investigation, litigation avoidance and monthly reporting.

    Responsibilities

    • Coordinate with Work Care (claim triage and nurse case management company), as appropriate
    • Coordinate accident investigation, claim process and return to work efforts with local store manager, leave coordinator and HR as necessary
    • Coordinate with HR for wage and employment issues
    • Wage information through Equifax Review file for retention of nurse case management
    • Evaluate need for surveillance, social media check, etc
    • Review court decisions and consider appeal Coordinate with TPA and Managed Care Companies for monopolistic states
    • Review SPOA (Strategic Plan Of Action)
    • Conference calls with claim adjusters for ongoing strategies
    • Participate in litigation conference calls
    • Reserve/settlement authority
    • Monthly reporting of claim activity

    Qualifications

    • Education: Bachelors/4 Yr Degree  and current/valid Texas WC and liability adjusters license
    • Experience: 5-10 years, WC and Claims Management experience
    • Multi state jurisdictional knowledge of workers compensation in order to manage TPA and perform claim audits
    • Knowledge of multi line insurance products and basic finance and accounting principles
    • Ability to manage one-off mid to large size projects as they arise, i.e., store acquisitions
    • Must have ability to evaluate WC and TxNS exposure and litigation exposure and have strong negotiation skills
    • Proficient in Microsoft applications
    • Internal Posting Dates: 10/11 - 10/24

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