This position is responsible for managing assigned claims to ensure claims are managed to our best practices, including compensability review, appropriate treatment, and mitigating lost time, in a timely and cost-effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time and or/medical only claims, or litigated files.
The preferred location of this position is for our corporate office in Neenah, WI, but we will consider a hybrid/remote model of work from home and in the office arrangement for the right candidate.
Develop medical management strategy and give the providers information necessary to facilitate an aggressive return-to-work plan.
Discuss cost-effective treatment alternatives when appropriate and ensure that injured workers have aggressive treatment plans in place.
Where appropriate, channel injured workers to network providers.
Analyze, review, negotiate, and settle Workers' Compensation claims to varying complexity, in a thorough manner and with minimal supervision.
Control legal and medical bills/records to ensure savings for the company.
Make contact with injured workers and employers within 24 hours.
Work effectively with doctors, attorneys, insured, injured employees, and associates.
Review and authorize reasonable and necessary medical treatment and associated diagnostic testing on assigned claims.
Participate in prehearing settlement conferences.
Establish and monitor reserves to adequately reflect the exposure, and make appropriate changes as each file develops.
Uphold highest level of service orientation toward all customers.
Assist in agency management by providing feedback to Underwriting.
Knowledge of medical terminology and the ability to interpret and understand medical records.
Exceptional computer and organization skills.
Excellent verbal and written communication skills.
Ability to work independently.
Great problem-solving and decision-making skills.
Nursing or Athletic Training experience, or medical background.
Bachelor's degree or equivalent work experience.
Advanced insurance courses such as AIC, CPCU, and CIC.
Three to five minimum years of experience handling advanced Workers' Compensation claims.
Focus on Fitness: Our beautiful fitness facility is available for associates and their family members to use. It’s equipped with plenty of spin bikes, treadmills, step machines, ellipticals, free weights, and a complete circuit system. We also offer:
Instructor-led fitness classes
Free personal trainer services
Walking and biking trails around the building grounds
For associates working from our Middleton office, the field, or their homes, we offer a reimbursement program for fitness club memberships.
Onsite Café: There’s something for everyone to enjoy at SECURA’s affordable onsite café! Lunch options include a variety of entrees, a salad bar, hot soups, made-to-order sandwiches, fresh fruit, snacks, and more! The café staff is also more than happy to accommodate any dietary restrictions you may have. We also have breakfast options including a variety of freshly brewed Door County Coffee in case the line at the drive-thru was too long.
Casual Dress Code: We want our associates to be comfortable at work. Outside of customer and public meetings, associates are allowed to wear jeans and a business casual shirt Monday through Friday.
Mothers’ Rooms: Our home office has three comfortable private rooms for nursing mothers to use during the work day.
Vehicle Maintenance: We offer offsite vehicle maintenance services for our home office associates. Your car is picked up in the morning and returned before you leave for the day.
Professional Development: We expect high performance from our associates. We understand for that to happen we need to invest in associates’ growth, both personally and professionally. We offer numerous in-house professional development opportunities to our associates, including mentoring programs and insurance education. We also encourage internal movement between roles to explore other areas.
Orientation: We want our new associates to feel right at home here, which is why we have a variety of programs to help associates get settled. Quick Start is a two-day program designed to help you get to know other new associates and learn about all of our departments directly from division leaders. We also offer new associate mentoring lunches where new and veteran associates have lunch together. It’s a great way to get to know other people in the company and a chance to ask questions.
Rewards and Recognition: Hard work doesn’t go unnoticed at SECURA. Associates who go above and beyond can look forward to performance bonuses and length of service rewards. We also have a High Five Program with awards catered to associates’ interests. Associates can give High Fives to other associates – this isn’t just for managers to reward!
Game Room: Kick back after a long day or challenge fellow associates to a lunchtime duel in the Game Room. It is equipped with a Nintendo Switch, pool table, bag toss, and ping pong table.
Get Involved: SECURA associates are encouraged to get involved in their communities. Click here to see how.
Be Yourself: Stand up, stand out, and let us know what’s on your mind. SECURA’s culture flourishes on multi-level diversity. When associates are themselves at work, they freely share ideas while remaining friendly, tolerant, and open to others’ opinions. Our associates are our most valuable assets, and we need everyone working together to achieve mutual victory.