Job Details

Job Title

Claims Coordinator
Posted: 2/10/2020

Location

World Headquarters, TX
2481 Manana Drive
Dallas, TX 75220

Description

Directs and coordinates activities involving claims for injuries to guests and team members as well as property and casualty damage.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Focus on guest service including calling both guests and employees to determine if a claim should be set up with the third party administrator.

Professionally and efficiently respond to guests and employees calls. Strong ability to work with escalated guest concerns.

Works closely with Guest Relations Representative on guest incidents.

Submits General Liability and Workers' Compensation and Property claims against the company to insurance carrier(s) for settlement, negotiates settlement with carriers and authorizes payment within approved authority levels.

Acts as liaison between employees, guests, store management, third party administrator, medical providers and other vendors.

Processes claim information (i.e., incident reports, medical bills, medical reports) and other confidential information as needed.

Maintain Risk Management Information System by daily coding of claims, set up of new locations, making changes in store hierarchy and management and updating codes for changes in the business.

Updates Human Resource Representative of work injury resulting in lost time.

Assist insurance carrier in the investigation of accidents and injuries and cooperates in the preparation of material and evidence for organization use in hearings, lawsuits, and insurance investigations.

Oversees the administration of workers' compensation and general liability programs, including working with the insurance carrier to reduce employee lost time and mitigate losses.

Coordinates loss control efforts between operations and other departments.

Supports Director of Risk Management in daily management of departmental activities.

Communicates with medical providers, adjusters, attorneys, and other relevant parties regarding disabilities and claims.

Ensures monthly insurance premiums are paid to carriers. Calculates and pays state worker's compensation premiums as required. Reviews invoices and processes for payment, including sending bills to vendor, filling out check requests, mailing payments, maintaining transaction record, filing check copies, and identifying duplicate payments.

Generates periodic reports that provide statistical information regarding employee injuries, illnesses and guest incidents to assist stores in controlling cost and maintaining a safe environment. Analyzes claim liability reports for trends and cost saving measures.

Prepares weekly shoe program deduction spreadsheet, maintains shoe payment records, reconciles shoe allowances and prepares monthly invoices from shoe vendors for submission to Accounts Payable.

Sets up new locations with risk management vendors prior to new store openings. Prepares necessary new store opening packets for stores.

Gathers information for property damage claims and works with store personnel and insurance company representatives in either payment of claims or making claims for damage to company property with third parties.


SUPERVISORY RESPONSIBILITIES
No Supervisory Responsibilities.

QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE
Bachelor’s degree (B. A.) or equivalent from four year college (preferred); or one to two years related experience and/or training; or equivalent combination of education and experience.

LANGUAGE SKILLS
Individual must have excellent communication and organizational skills. Ability to exercise good judgment in decision making and problem solving. Must be teamwork oriented.

REASONING ABILITY
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of instructions and deal with several abstract and concrete variables.

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand; walk; and stoop, or kneel. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, and ability to adjust focus.

WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.
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