Description
We are seeking a Workers' Compensation Excess/SDF Claims Specialist to join our team. You will be responsible for submitting timely and appropriate excess reports to excess companies on workers’ compensation claims on behalf of our customers, maintaining specific contract timelines and financial thresholds. You will also pursue, perfect, and manage SDF claims to conclusion pursuant to company and state regulations.
Key Responsibilities
- Coordinate with clients and their insurance agents to ensure excess insurance policies and declaration pages are available for each year with open claims.
- Provide timely notification to excess carriers that we have been retained to provide Third Party Administration services.
- Identify retention levels for each excess insurance policy period and special reporting requirements.
- Provide required reporting of all claims to the appropriate excess carrier, including Initial Notice of a claim, Follow-up/Supplemental Reports, and Final Reports.
- Maintain communication with claims specialists and supervisors regarding excess reporting.
- Evaluate files for SDF potential and pursue to meet State requirements for successful Fund reimbursement.
- Contact employers, attorneys, field representatives, and doctors in a timely manner.
- Notify SDTF of potential settlements on SDF cases and advise claims specialists of the Fund's settlement approval procedures.
- Ensure all file handling includes consistent system documentation and timely compliance with State reporting.
- Maintain file diary and keep all files current according to company standards.
- Correspond with excess carriers and the SDTF regarding excess/SDF issues.
- Update SDF status reports to certain clients on a quarterly basis and excess status reports to excess carriers on a 3-, 6-, or 12-month basis.
- Provide SDTF with initial and annual reimbursement requests.
- Monitor on diary, complete SI-19 forms, and facilitate customer execution and timely filing with FLDFS.
- Perform other duties as assigned.
Skills, Knowledge & Expertise
- 1-2 years of claims-handling experience in Florida WC law.
- 1-2 years of office experience.
- Active Adjuster license (FL 5-24 or 5-20/6-20).
- Working knowledge and experience handling Workers’ Compensation claims.
- Knowledge of state-specific Workers’ Compensation statutes.
- Ability to effectively operate a personal computer and related claims and business software.
- Good communication skills, both oral and written; good customer service skills.
- Excellent organisational skills. Team player. Good attendance.
Benefits
- Medical, dental, and vision plans to support your health and that of your family.
- A 401(k) plan with employer matching.
- Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.
- Paid holidays.
- Life insurance and short-term and long-term disability coverage.