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Inside Sales Agent

CalOptima

Inside Sales Agent

Orange, CA
Paid
  • Responsibilities

     

    The position will be responsible for the daily management of the Workers’ Compensation program offered to employees across the organization. Using analytical, organization and communication skills, this position is responsible for providing subject matter expertise on administration, compliance, vendor management, reporting, as well as employee communication and education of the Workers’ Compensation program.  The incumbent will conduct research and data analysis pertaining to various aspects of the plan, identify and develop process improvements, and implement programs (e.g. return to work) to ensure compliance.

     

    POSITION RESPONSIBILITIES:

    • Serves as liaison between employees, management, vendors and broker; works closely with internal and external stakeholders on work-related claims and other activities of the Workers’ Compensation program.
    • Primary point of contact for employee inquiries and assist in resolving escalated questions, claims, and issues.
    • Develops Workers’ Compensation initiatives including but not limited to a return to work process, minimizing risk of job injury, routine data analyses, review of claims including timely contact, and achieves key metrics in alignment with risk assessment.
    • Analyzes claims to identify trends as well as identify opportunities for improving service delivery methods and procedures; recommend solutions when applicable.
    • Develops, implements, and monitors cost containment programs to reduce workers’ compensation liabilities; monitors and controls changes to industrial accident leave and light duty benefit accounts; assesses facts and determines necessity for reporting claims to excess insurance carrier.
    • Facilitates regular meetings with vendor, broker, and operations to discuss trends, claims status/history, claims handling concerns, and deliver potential risk assessments.
    • Collaborates with vendor and broker to ensure the best outcome of claims from first report to settlement for employees, analyze plan utilization and benchmarking data to propose enhancements to offerings, and holding the external vendors accountable for service level agreements.
    • Monitors the legal and regulatory environment impacting the Workers’ Compensation plan; makes recommendations for changes to policies and practices as appropriate.
    • Oversees implementation of new Workers’ Compensation programs and suggest changes to current programs.
    • Maintains internal case files to ensure alignment with, policies.
    • Serves as back up to the HR Representative (Benefits).
    • Other projects and duties as assigned.

    Required Skills

     

    • Connect both technical and process implications to Workers’ Compensation program.
    • Work independently and effectively as part of a team.
    • Work in a demanding, change-oriented, fast-paced environment in order to meet time critical deadlines.
    • Identify issues and problems, develop solutions and prepare recommendations.
    • Ensure compliance with legal requirements and support all Workers’ Compensation compliance initiatives.
    • Demonstrates flexibility, organizational and self-motivation skills.
    • Communicate both verbally and in writing.
    • Maintain effective working relationships with all levels of staff.
    • Effectively utilize computer and appropriate software (e.g., Microsoft Office Word, Excel, and Outlook).

    Required Experience

     

     

    EXPERIENCE & EDUCATION:

    • Bachelor’s degree in Human Resources, Business, Communications or other related field; or equivalent work experience is required.
    • Worker’s Compensation Claims Professional (WCCP) or Worker’s Compensation Claims Administration (WCCA) certification(s) preferred.
    • 5+ years Workers’ Compensation administration required.
    • Experience utilizing an HRIS system such as Ceridian Dayforce preferred.

                                                                                                                              

    KNOWLEDGE OF:

    • Federal and state regulatory and other requirements and practices related to Workers’ Compensation administration.
    • Effective methods and techniques for measuring effectiveness, utilization, value proposition, and cost effectiveness of Workers’ Compensation programs.
    • Policies and procedures, general responsibilities, requirements and regulations pertaining to the human resources department.
    • Methods and techniques for organizing and implementing programs or projects.

     

    Grade:  M

     

    #CB

  • Qualifications

     

    • Connect both technical and process implications to Workers’ Compensation program.
    • Work independently and effectively as part of a team.
    • Work in a demanding, change-oriented, fast-paced environment in order to meet time critical deadlines.
    • Identify issues and problems, develop solutions and prepare recommendations.
    • Ensure compliance with legal requirements and support all Workers’ Compensation compliance initiatives.
    • Demonstrates flexibility, organizational and self-motivation skills.
    • Communicate both verbally and in writing.
    • Maintain effective working relationships with all levels of staff.
    • Effectively utilize computer and appropriate software (e.g., Microsoft Office Word, Excel, and Outlook).