Claims Specialist # 26-24738

Duration :12 Months Contract

Please Note: . The position is located at the project construction site in Winnemucca Nevada and is not remote work (Day 1 Onsite). The anticipated work schedule is Monday through Saturday 6:00 a.m. to 4:30 p.m.

Overview :
The Claims Administrator is responsible for implementing all aspects of the project workers compensation program under the guidance of Clients claims team. This position will also assist with the administration of auto and other insured claims. While this is Clients contingency position theemployee is seconded to Clients . The Claims position works under the direction of Clients Head of Workers Compensation and the Clients Claims Director acting independently to manage routine matterswhile keeping Clients Claims fully informed at all stages.
Responsibilities:

• Communicates effectively with injured workers medical professionals insurers brokers
• internal/external counsel corporate management and various related regulatoryagencies.
• Develops and maintains project-specific workers compensation claims manual compliance of ESIS NV provider panel related processes and procedures for statutory claims.
• Implementsimprovements based on lessons learned legislative changes or Court decisions and Clients operating imperatives.
• Develops and provides onsite training related to workers compensation.
• Monitors claims activity to identify early negative claim trends or other issues that may negatively impact project performance.

Responsible for oversight and processing of workers compensation claims:

• Responsible for initiating preparing and maintaining all documentationassociated with claims.
• Investigates and documents eligibility for workers compensation benefits andcommunicates same to insurer and related interested parties.
• Assists with investigation and coordination of issues surrounding subrogation.
• Interprets laws and regulations determines appropriate courses of action andpresents solutions to resolve the claims.
• Identifies potential subrogation issues for internal discussion and next steps.
• Monitors claim resolution activities implemented by insurer(s).
• Maintains Project Risk Management Information System (RMIS).
• Directs and monitors the activities and performance of Clients insurance provider toensure compliance with applicable regulations.
• Implements monitors and ensures compliance of Special Account requirements.
• Conducts regular claim reviews claim audits and prepares related reports.
• Interfaces with insurer to effectively manage claims including but not limited to authorizing claim reserve changes authorizing insurer referral to outside counsel and assessing and approving settlement strategies.
• Coordinates and supports early return to work.
• Manages relationships with onsite clinic panel physicians and other medical providers to ensure effective claims management and return to work.
• Works with injured worker and supervision on developing and implementingreturn to work plan.
• Assists in management fitness for duty and ADA accommodation issues as needed.
• Assists Clients Risk Management in the defense of litigation or other complex case support. (i.e. responding to interrogatories and other discovery requests).
• Assists with gathering information and filing other insured claims as requested.
• Performs other tasks as required by Clients Claims.

Requirements:

• Requires a Bachelors Degree or at least 3 years of experience in the field or in a relatedarea.
• Extensive knowledge of / experience with workers compensation and occupational rehabilitation procedures practices and processes.
• Extensive knowledge of claims resolution techniques and strategies legal principles
• related to claim resolution and familiarity with all phases of the litigation process.
• Working knowledge of / experience with bodily injury and 1st and 3rd party property damage claims practices and processes.
• Working knowledge of / experience with and other insured claims practices andprocedures.
• Relies on experience and judgment to plan and accomplish goals.
• Highly skilled in written and verbal communication.
• Proficient with computer skills and knowledge.
• Ability to create edit and format high-quality documents using Microsoft Word 365 applications (Outlook Word Excel Power Point etc.)
• Collaborate with team members in real time through Outlook and Teams applications.
• Typing skills / proficiency (45-65 WPM).
• Bilingual language proficiency (i.e. English and Spanish) is a plus.

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions please visit

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race colour religion sex sexual orientation gender identity national origin disability or status as a protected veteran.

AI Statement: By applying you acknowledge that AI-assisted tools may be used during hiring.

Required Experience:

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