Job Description

PURPOSE OF POSITION:

Responsible for the management of Foster Farms’ third party administrator (“TPA”) for the worker's compensation program. Responsible for claim management strategies critical to the organization's success. This position will liaise with our third-party claims administrator, employees, medical providers, counsel, supervisors, human resources and leave of absence coordinator(s) with a focus on resolving complex claims, ensure timely and equitable claim payments by the TPA, and advocating for the employees’ full recovery, return-to- work, and effectively manage claims resolution. Will be a strategic partner to Operational and Functional leadership in successfully managing claims and recovery outcomes with our TPA. This position serves as an advocate for injured employees while ensuring that the quality of workers' compensation claims handling practices is consistent for all claims.  Responsible for developing support procedures and programs that facilitate a strong culture of caring for injured employees at every organizational level. Will seek to minimize the potential risk and liability to the Company associated with workers' compensation and provides leadership, expertise, and training to reduce the cost of employee injuries overall. Track injury trends in the Company and develop action plans to prevent and address identified accident trends proactively. Responsible for reporting, investigation, and analysis; litigation management; resolution/outcome management; and the delivery of claim information. Manages litigated and moderately complex claims and is entrusted with significant settlement authority.

ESSENTIAL JOB FUNCTIONS:

Manage Workers’ Compensation claims having oversight of TPA’s and insurance companies to assure compliance with its policies and procedures.

Conduct quarterly claim reviews with TPA and participate in annual claim audits with the corporate claims team.

Work closely with the legal counsel on litigated claims and claims with a high potential of litigation.

Build partnership with TPA and develop a strong team to effect positive results.

Manage and lead TPA in aggressively managing open claims to a satisfactory conclusion.

Ensure TPA compliance with best claim practices, manages claims diligently and ensure compliance with WC Regulatory Reporting and Postings.

Ensure TPA compliance with contract, service level agreements and manage spending on services to ensure appropriateness.

Working with TPA to drive workers’ compensation results through various cost control initiatives and litigation management. Develop key metrics to measure results.

Will serve as an advocate for injured employees while ensuring that the quality of Workers' compensation claims handling practices with TPA are consistent for all claims. 

Work with TPA, local HR leaders and operations management to establish effective return to work programs, while assessing level and duration of any restrictions.

Collaborate with Safety teams in the proactive mitigation of workplace injuries, accidents, incident investigations and management reporting.

Provide field education and support, development and implementation of programs to assist in managing incidents and claims

Keep abreast to changes in laws and state regulations related to claims.

Ensure adequate and timely reserving practices. Provide timely and effective communications to internal constituents of increased exposure or material reserve changes.

Review and as appropriate, approve Adjuster settlement requests and/or reserve increase up to authorized amount.

Maintain effective work comp fraud mitigation program working with the TPA, service providers, local district attorney’s offices and company managers. 

Effectively interface and collaborate with: internal operational and functional leadership, human resources, legal, risk management; external with TPA, insurers, medical providers, consultants, legal counsel, claims systems and technologies, experts and related professionals.

Assist work comp actuary annually to establish appropriate IBNR reserve and reporting requirements for state and insurance purposes.

ADDITIONAL FUNCTIONS:

Performs other duties and responsibilities as assigned

Qualifications

REQUIREMENTS:

Education: Bachelor’s degree from an accredited college or university with major coursework in risk management, law, claims or related technical field.

Experience: Minimum of 5-7 years of casualty claims experience working for an insurance carrier, TPA or risk management department.

Certifications/Designations: AIC, ARM, CPCU or equivalent certification(s) preferred

Proficient with Insurer Claims systems and Risk Management Information Systems (RMIS).

Strong Computer skills including Excel, Word, PowerPoint, Gmail, Google Suite

Excellent verbal and written communication skills

Empathetic and caring demeanor with a strong focus on customer service.

Demonstrated ability to effectively build, develop and collaboratively work within cross- functional teams

Strong analytical, influential, interpersonal, and organizational skills

Must be results-oriented with the ability to drive continuous improvement within the organization

Ability to travel for business 5-10% as needed, and work hours as required based on business demands

Additional Information

All your information will be kept confidential according to EEO guidelines.

Foster Farms is an Equal Opportunity Employer – Minorities, Females, Veterans and individuals with disabilities are encouraged to apply.

Foster Farms participates in E-Verify during the hire process at all locations for all new employees.