Team Member Claims Lead
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Job Summary
Reporting to the Sr. Casualty Claims Manager, the Team Member Claims Lead supports Brinker's Return to Work program Worker's Compensation (WC) and Texas Non-Subscriber (TXNS) by initiating timely and consistent contact with injured team members and restaurant management. Mitigates losses by monitoring cost control activities and managing Third Party Administrator (TPA). Improves team member morale and restaurant productivity by helping team members return to work. Serves as a mentor and trainer to other Team Member (TM) claims adjusters and team members.
Key Performance Elements/Essential Functions
Leads and develops a team (2) responsible for supporting TM injuries ensuring quality, accuracy, and timely resolution of claims.
Monitors the work of team members and/or TPA to ensure reserves are adequately set. Analyzes any problematic trends and takes steps to avoid recurrence, appropriately escalating issues if needed.
Evaluates the efficiencies of the team, identifies barriers and moves to eliminate them where possible and practicable
Establish rapport and build relationships with injured team members
Explain workers' compensation process
Assess team member's understanding of injury, treatment, and satisfaction with care provided
Listen to concerns, encourage them to call with problems/concerns
Coordinate restaurant communication with team member
Contact treating physicians before and after visits
Obtain work restrictions
Explain return to work program to doctor and team member
Determine team member's condition, treatment plan, and return to work status
Identify cases requiring additional medical management
Identify cases requiring surveillance
Act as liaison between restaurant management, team member, doctor, claim adjuster, to facilitate the return to work whether regular duty or transitional
Monitor team member compliance with prescribed therapy
Keep restaurant management informed as to the claim status
Complete additional projects and assignments as requested by Sr. Casualty Claims Manager
Create and maintain case files in an organized, systematic manner
Escalate concerns or issues to the Sr. Casualty Claims Manager or Sr. Director of Risk as needed
Identify claims requiring notice to carrier and facilitate in conjunction with insurance broker
Provide feedback as appropriate to Loss Prevention on potential safety opportunities identified during investigations
Provide reporting and analysis based on productivity and results metrics
Prepares for and participates in file reviews and claim audits as required
Cultural Beliefs
Feedback's Priceless - Sees more through other's feedback.
Own it - Owns, drives, and achieves desired key results.
Win Together - Works across boundaries to achieve key results.
Trust Matters - Acts in a manner that cultivates trust in others.
Thinking Forward - Thinks and acts in a manner to deliver desired future results.
Qualifications
Education/Training:
College degree or equivalent work experience
Worker's compensation program experience required
Risk or Insurance professional designations preferred but not required
User level familiarity with IBM PC and business software (Microsoft Excel and Microsoft Word) required
User level familiarity with Risk Management Information Systems (claims handling software) required
Knowledge/Skills/Abilities:
Supervisory, organizational and interpersonal skills
Superior negotiation skills
Possesses strong oral and written communication skills
Works with minimal supervision to accomplish tasks
Prioritizes work to meet appropriate deadlines
Handles multiple tasks with competing and conflicting requests
Handles sensitive and confidential information appropriately
Draws conclusions and makes recommendations
Ability to communicate and establish a rapport with people of various backgrounds, cultures, and professions
Bilingual (Spanish) is a plus
Strong listening skills
Pleasant and clear telephone speaking voice
Strong customer service skills, including a high level of enthusiasm and energy
Work
Experience:
5-7 years WC claims handling experience required
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
Job Summary
Reporting to the Sr. Casualty Claims Manager, the Team Member Claims Lead supports Brinker's Return to Work program Worker's Compensation (WC) and Texas Non-Subscriber (TXNS) by initiating timely and consistent contact with injured team members and restaurant management. Mitigates losses by monitoring cost control activities and managing Third Party Administrator (TPA). Improves team member morale and restaurant productivity by helping team members return to work. Serves as a mentor and trainer to other Team Member (TM) claims adjusters and team members.
Key Performance Elements/Essential Functions
Leads and develops a team (2) responsible for supporting TM injuries ensuring quality, accuracy, and timely resolution of claims.
Monitors the work of team members and/or TPA to ensure reserves are adequately set. Analyzes any problematic trends and takes steps to avoid recurrence, appropriately escalating issues if needed.
Evaluates the efficiencies of the team, identifies barriers and moves to eliminate them where possible and practicable
Establish rapport and build relationships with injured team members
Explain workers' compensation process
Assess team member's understanding of injury, treatment, and satisfaction with care provided
Listen to concerns, encourage them to call with problems/concerns
Coordinate restaurant communication with team member
Contact treating physicians before and after visits
Obtain work restrictions
Explain return to work program to doctor and team member
Determine team member's condition, treatment plan, and return to work status
Identify cases requiring additional medical management
Identify cases requiring surveillance
Act as liaison between restaurant management, team member, doctor, claim adjuster, to facilitate the return to work whether regular duty or transitional
Monitor team member compliance with prescribed therapy
Keep restaurant management informed as to the claim status
Complete additional projects and assignments as requested by Sr. Casualty Claims Manager
Create and maintain case files in an organized, systematic manner
Escalate concerns or issues to the Sr. Casualty Claims Manager or Sr. Director of Risk as needed
Identify claims requiring notice to carrier and facilitate in conjunction with insurance broker
Provide feedback as appropriate to Loss Prevention on potential safety opportunities identified during investigations
Provide reporting and analysis based on productivity and results metrics
Prepares for and participates in file reviews and claim audits as required
Cultural Beliefs
Feedback's Priceless - Sees more through other's feedback.
Own it - Owns, drives, and achieves desired key results.
Win Together - Works across boundaries to achieve key results.
Trust Matters - Acts in a manner that cultivates trust in others.
Thinking Forward - Thinks and acts in a manner to deliver desired future results.
Qualifications
Education/Training:
College degree or equivalent work experience
Worker's compensation program experience required
Risk or Insurance professional designations preferred but not required
User level familiarity with IBM PC and business software (Microsoft Excel and Microsoft Word) required
User level familiarity with Risk Management Information Systems (claims handling software) required
Knowledge/Skills/Abilities:
Supervisory, organizational and interpersonal skills
Superior negotiation skills
Possesses strong oral and written communication skills
Works with minimal supervision to accomplish tasks
Prioritizes work to meet appropriate deadlines
Handles multiple tasks with competing and conflicting requests
Handles sensitive and confidential information appropriately
Draws conclusions and makes recommendations
Ability to communicate and establish a rapport with people of various backgrounds, cultures, and professions
Bilingual (Spanish) is a plus
Strong listening skills
Pleasant and clear telephone speaking voice
Strong customer service skills, including a high level of enthusiasm and energy
Work
Experience:
5-7 years WC claims handling experience required
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
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