Berkshire Hathaway Homestate Companies

Careers

Workers Compensation Claims Director — Omaha, NE

Date Posted: 07/20/2010

We have an opening in our Omaha, Nebraska, office for a Workers Compensation Claims Director to lead the development, management, and performance of the Company's workers compensation claims management operation in all states other than California (the "national claims operation").  We are looking for an exceptional leader who will create an industry-best operation with a proud, upbeat, motivated culture.  Responsibilities include:

• Develop and manage the Company's national claims operation, including claims adjusting, compliance, and employee development.
• Oversee the third party administrators with whom the Company contracts to manage workers compensation claims, including ensuring that those services are performed to a high standard of quality and at an efficient cost.
• Ensure that the national claims operation produces exceptional results in terms of regulatory compliance, timely claim closure, high client satisfaction with claim services, high scores on external claim audits, claim cost control, and appropriate allocated and unallocated expenses per claim.
• Ensure close coordination and communication between the national claims operation and the other coponents of the Company's workers compensation claims management program, including medical bill review, utilization review, legal counsel, special investigations, and the California claims operation.

QUALIFICATIONS:

Education:

• Bachelors Degree or equivalent work experience.

Experience:

• At least five years experience managing a multi-jurisdictional workers compensation claims management operation. Experience creating such an operation is a plus.
• Experience leading or coordinating the creation of a claims management training program and an information resource for multi-jurisdictional workers compensation claims adjusting and compliance.
• Experience communicating with workers compensation insureds, claimants, medical providers, legal professionals, brokers, and agents, as well as state regulatory and licensing authorities.
• Experience creating and maintaining vendor panels in states nationwide, including law firms, medical providers, nurse case managers, med-legal service providers, and vocational rehabilitation consultants.

Industry Knowledge:

• Knowledge of the requirements and procedures for licensing workers compensation claims adjusters in states nationwide.
• Knowledge of the requirements and procedures for reporting information relating to claims in states nationwide, including the triggers and deadlines for reporting, the correct forms for reporting, and the preservation of legal remedies through timely and appropriate reporting.
• Knowledge of the requirements in states nationwide for claims handling; including calculating benefits, deadlines for the payment of benefits, mandatory language in notice letters, the use of state forms, the principal strategic and tactical issues relating to claims management in each jurisdiction, and the standards and procedures for accepting and denying claims.

Language Ability:

• Able to read, analyze, and interpret complex medical, financial, and legal documents.
• Able to respond to technical inquiries or complaints from Company employees, external sources, and regulatory or auditing entities.
• Able to effectively present information to top management, public groups, and/or boards of directors.

Math Ability:

• Ability to calculate figures and amounts such as discounts, interest, and percentages.

Reasoning Ability:

• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Technical Skills:

• Knowledge of office operations, workflow analysis, business financial principles, and current technologies in telecommunications, data entry and file management.

Computer Skills:

• Knowledge of Microsoft Office software; Able to quickly master proprietary or vended claims management software.

Certificates or Licenses:

• Licensed to adjust workers compensation claims in one or more jurisdictions, preferably including Texas.

BERKSHIRE  HATHAWAY HOMESTATE COMPANIES

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