Senior Associate, Claims-Workers

POSITION SUMMARY

POSITION SUMMARY: Is responsible for varied Employee Claims and Safety office duties including but not limited to the creation of work plans, preparation of reports, analysis of data and metrics, presentation of findings, and the provision of administrative and project support. In addition to working autonomously, this position is differentiated from the Associate role through a demonstration of one or more of the following: subject matter expertise, ownership and accountability for complex assignments, and the ability to work in a supervisory capacity leading, coaching, and training others.

It is a mid-level professional track position and will offer training and continuing education to support a career in management and leadership within BAYADA Home Health Care.

• Exemplifies characteristics of The BAYADA Way: compassion, excellence and reliability.
• Three (3) to five (5) years successful experience in an insurance or related field
• Possesses effective project management skills including the ability to facilitate and organize.
• Demonstrates well-developed presentation skills.
• Proficient in Microsoft computer products including Word, Excel, Access, PowerPoint and Outlook.
• Demonstrates excellent leadership, interpersonal, and motivational skills.
• Solid record of goal achievement and exceeds performance standards.
• Able to effectively handle multiple tasks.
• Ability to arrange information and files in a useful manner.
• Understands the company’s organizational structure, financial status, and operational goals/objectives.
• Embraces the organization’s entrepreneurial spirit through the recognition and capitalization of opportunities and a healthy challenge of the status quo.
• Ability to read, write and effectively communicate in English.

• Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
• Develop working knowledge of BAYADA’s mission, services, people, organization, policies and procedures.
• Perform varied and difficult aspects of the Associate position.
• Understand BAYADA’s Employee Claims policies as well as the applicable state Workers’ Compensation laws that govern our work.
• Act as a trusted advisor and become a subject matter expert with regard to Employee Claims functions and processes.
• Assume ownership of, and be accountable for, complex assignments.
• When requested, work in a supervisory capacity leading, coaching, and training others including but not limited to those individuals who function in the Associate role.
• Analyze and identify the resources required to complete the office’s routine work plan or special projects.
• Provide day-to-day operational management support of the office’s routine work plan or special projects.
• Assist in the creation and management of policies, practices and procedures related to BAYADA’s Employee Claims and Safety office.
• Establish and maintain proper file reserves.
• Conduct behavior in a professional manner.
• Progressively assume additional responsibilities as needed.
• Demonstrate solid performance or exceed performance standards in key job dimensions/attributes as defined on the Performance Appraisal for Office Staff and continually improve level of improvement.
• Perform related duties, or as required or requested by supervisor.

• Handle a caseload of between one hundred (100) and one hundred fifty (150) active Workers’ Compensation claims while maintaining accurate and complete information on each assigned file.
• Provide customer service for routine claim questions, and direct more complex issues to BAYADA’s third party administrator.
• Maintain a strategic focus and concentrate efforts on the closure of all active Workers’ Compensation claims particularly those valued at $10,000 or more.
• Ensure that each BAYADA office has a reliable Panel List of Providers and maintain regular contact with office directors to guarantee continued satisfaction with ECS’ outside medical vendors.
• Assist with or handle litigated Workers’ Compensation claims and strive to resolve these files in the most prompt and cost-efficient manner.
• Coordinate placement of injured workers in modified or…