Leave of Absence Specialist

Santa Fe - Argentina

Monthly Salary: Not Disclosed

Posted on: 14 hours ago

Vacancies: 1 Vacancy

Job Summary

ABOUT US

Fashion Nova is an inclusive fashion-forward and trend-driven apparel and lifestyle brand that celebrates all dimensions of confidence. We use our platform to spread positivity with brands for women men curve luxe sport swim beauty and kids. We are obsessed with creating the best experience available for our customers and employees.

Fashion Nova was built on the backbone of individuality and inclusiveness. Our brands are worn and celebrated worldwide by customers celebrities and influencers because of our uniquely creative and talented employees.

ROLE OVERVIEW

The Manager Workers Compensation is responsible for supervising and monitoring Fashion Novas Workers Compensation program at all company owned and operated locations. The Manager Workers Compensation will be responsible for developing and collaborating successful partnerships with our associates Third-Party Administrators (TPAs) internal stakeholders and service providers.

POSITION IS ONSITE IN SANTA FE SPRINGS HYBRIDREMOTE WORK IS NOT POSSIBLE

RESPONSIBILITIES

Analyzes and processes complex or technically difficult workers compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims
Manages reserve adequacy throughout the life of the claim providing Finance with monthly updates
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost-effective claims resolution
Coordinates vendor referrals for additional investigation and/or litigation management
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
Manages claim recoveries including but not limited to subrogation Second Injury Fund excess recoveries and Social Security and Medicare offsets
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
Communicates claim activity and processing with the claimant and Leadership; maintains professional client relationships
Ensures claim files are properly documented and claims coding is correct
Refers cases as appropriate to supervisor and management
Partners with multiple departments to coordinate and supervise the Return-to-Work program for team members to ensure work restrictions and transitional work guidelines are being adhered to
Availability andor work evenings and weekends as dictated by business needs

ROLE REQUIREMENTS

Five plus years of experience processing lost time workers compensation claims preferably for an employer with a high-deductible program
Bachelors degree in Business Administration or Finance
IIA AIC AEI andor CPCU Designations Self-Insured Certification highly encouraged
Subject matter expert of appropriate insurance principles and laws for line-of-business handled recoveries offsets and deductions claim and disability duration cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business
Excellent oral and written communication including exceptional presentation skills
Advanced knowledge of Google Suite
Experience with fraud investigations
Knowledge of medical terminology
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Clear and conceptual thinking ability; excellent judgment troubleshooting problem solving analysis and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Fashion Nova LLC and subsidiaries thereof is an Equal Opportunity Employer. We are steadfast in our commitment to equal employment opportunities and pledge that these objectives are reflected in all aspects of our daily operations. We will continue to recruit hire train and advance in employment qualified individuals in all job titles without regard to race color national origin gender sexual orientation gender identity religion age status as a protected veteran criminal history or status as an individual with a disability; and shall not discriminate against any individual any such characteristic nor any other classification protected by local state andor federal law.

NOTICE AT COLLECTION

Required Experience:

ABOUT USFashion Nova is an inclusive fashion-forward and trend-driven apparel and lifestyle brand that celebrates all dimensions of confidence. We use our platform to spread positivity with brands for women men curve luxe sport swim beauty and kids. We are obsessed with creating the best experience ...

ABOUT US

ROLE OVERVIEW

POSITION IS ONSITE IN SANTA FE SPRINGS HYBRIDREMOTE WORK IS NOT POSSIBLE

RESPONSIBILITIES

Analyzes and processes complex or technically difficult workers compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims
Manages reserve adequacy throughout the life of the claim providing Finance with monthly updates
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost-effective claims resolution
Coordinates vendor referrals for additional investigation and/or litigation management
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
Manages claim recoveries including but not limited to subrogation Second Injury Fund excess recoveries and Social Security and Medicare offsets
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
Communicates claim activity and processing with the claimant and Leadership; maintains professional client relationships
Ensures claim files are properly documented and claims coding is correct
Refers cases as appropriate to supervisor and management
Partners with multiple departments to coordinate and supervise the Return-to-Work program for team members to ensure work restrictions and transitional work guidelines are being adhered to
Availability andor work evenings and weekends as dictated by business needs

ROLE REQUIREMENTS

Five plus years of experience processing lost time workers compensation claims preferably for an employer with a high-deductible program
Bachelors degree in Business Administration or Finance
IIA AIC AEI andor CPCU Designations Self-Insured Certification highly encouraged
Subject matter expert of appropriate insurance principles and laws for line-of-business handled recoveries offsets and deductions claim and disability duration cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business
Excellent oral and written communication including exceptional presentation skills
Advanced knowledge of Google Suite
Experience with fraud investigations
Knowledge of medical terminology
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Clear and conceptual thinking ability; excellent judgment troubleshooting problem solving analysis and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines