Claims Administrator

Looking for a company that treats associates with respect, understanding, and appreciation? Looking for a company that is passionate about teamwork and the growth of it's associates and communities? That's WEIS!

Job Description:

The Claims Administrator provides support to the Risk Management Department in processing workers compensation, general liability, and pharmacy claims. The role works closely with our third-party administrators, and defense counsel to effectively manage the cost and closure of claims is required.  The role performs all tasks according to company policies and state and federal laws. The role serves as a liaison between an injured associate, our Third-Party Administrator (TPA), and Weis Markets. Under general supervision, the role provides administrative and technical support to insurance carriers and third-party administrators.  The role processes data, generates routine reports, and provides direct support to claim representatives. Other duties of the role include but are not limited to, answering telephones, filing, mail processing, document scanning, letter, and other document preparation.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The associate is responsible for the functions below, in addition to other duties as assigned:

• Reviews all new claims (intake)
• Contacts stores and/or claimants to review status of injured associate, assist claimant with any questions that may have regarding their claim, and follow-up with claimant throughout the claim for updated medical information/return to work status.
• Submits claim information into the appropriate TPA system.
• Be available to assist TPA, Store Management, or Risk Management with questions regarding the claim.
• Works with and obtains information from stores, claimants, vendors, field personnel and other internal or external resources. Investigates losses to determine cause, scope, and extent of damages and/or liability and possible subrogation.
• Reviews medical notes for work status and forward to appropriate TPA.
• Works with store managers to coordinate a return to work for injured associates.
• Answers correspondence and inquiries promptly from brokers/agents, TPA’s, claimants, doctors, attorneys, and outside vendors.
• Obtain, verify, and retain Insurance Certificate of Insurance (COI)
• Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities.
• Acts as a liaison between Weis Markets, its insurance provider and agents, and claimants
• Recognizes when to refer complicated claim situations to various areas, outside firms and TPA’s.
• Assists Supervisor, Claims Administration with OSHA 300 and 300A data and reports.
• Responsible for maintaining allocations spreadsheet.
• Updates electronic files with any additional information.
• Responsible for reviewing and securing video of Workers Comp and General Liability Incidents.
• May work on special projects as assigned.

Supervisory Responsibilities

This position currently has no supervisory responsibilities.

Qualification Requirements

To perform this job successfully, the associate must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required:

Education and/or Experience

• High school diploma or equivalent is required; associate or bachelor’s degree is preferred.
• Knowledge of Workers Compensation Laws and Occupational Safety and Health Administration Standards (OSHA)
• Knowledge and understanding of Workers’ Compensation and General Liability claim handling
• Knowledge of applicable statutes and regulations
• Keep updated on any changed in the workers’ compensation information by periodically attending seminars/workshops.

Weis Markets is an Equal Opportunity Employer:  Weis Markets is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of actual or perceived age, sex, sexual orientation, race, color, creed, religion, familial status, ethnicity, national origin, citizenship, disability, marital status, military or veteran status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. Applicants with a disability may be entitled to a reasonable accommodation under terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the ways things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Weis Markets.