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Claims Administrator
Claims Administrator
Full Job Description
WIN Waste Innovations is looking for a Claims Administrator position at our corporate office in Portsmouth, NH. This person is responsible for reviewing and investigating insurance claims related to damages or incidents caused by all our lines of business. Analyzing the validity of claims, determining liability, and managing the claims process to ensure fair and timely resolution. Working cross functionally with internal departments like legal, safety, environmental, and operations to gather information and resolve complex cases, acting as a dedicated claims professional within our business.
Key Responsibilities:
* Evaluate and verify all claims, including initial intake, investigation, and ongoing case management.
* Develop and implement best practices for claims handling, documentation, and reporting
* Ensure timely and accurate processing of claims, from initial reporting through resolution.
* Investigate and analyze insurance claims to determine coverage, liability, and the extent of damages or losses.
* Conduct interviews with claimants, witnesses, and experts to gather information and assess claims.
* Review policy details, medical records, repair estimates, and other relevant documentation. Support our TPA with the same in subrogation matters.
* Prepare and submit reports on claim status, outcomes, and financial impact to management and other stakeholders, and work to resolve any claims-related issues.
* Maintain up-to-date knowledge of federal, state, and local regulations regarding leaves of absence and workers' compensation.
* Ensure compliance with legal and company policies, including proper documentation and record-keeping and the POC for our DQ and Controlled Substance TPA.
* Maintain detailed records of claims, including notes on investigations, correspondence, status, outcomes, and settlement agreements.
* Maintain confidentiality and accuracy in processing sensitive employee information related to disability and compensation claims.
* Communicate effectively with employees, managers, legal, medical providers, and insurance carriers to gather necessary information and provide updates.
* Analyze trends and data related to claims to identify areas for improvement and ensure effective claims management and generate reports with relevant metrics.
* Serve as the main point of contact between our health partners for claims and employee testing and aid the operations team with annual scheduling.
* Maintain positive work environment by acting and communicating in a manner so that you get along with customers, clients, vendors, co-workers and management.
Who You are:
* Bachelor's degree in business administration, Human Resources, Insurance, or a related field.
* 4+ years of experience in administration of the following areas: Worker's Compensation, Short / Long term disability program preferred
* Knowledge of workers' compensation laws and related regulations is preferred.
* Strong analytical and problem-solving skills.
* Excellent communication and interpersonal abilities.
* Must be organized, process-driven, and can process high levels of detail.
* Must be proficient in Microsoft Office Suite and awareness of claims management software, and/or TPA applications is preferred.
What You'll Enjoy:
* Industry leading benefits
* Multiple and flexible medical plans
* Outstanding PTO program
* Floating Holidays
* Strong 401k program and company match
* Tuition reimbursement plan
* College loan reimbursement
* College scholarship program for dependents
* Parental Leave Program
* Inclusive culture
* Employee engagement events
* Employee resource groups
WIN Waste Innovations is a waste management company committed to delivering essential waste management solutions to customers and communities supported by our team of 2,300 employees. We believe in preserving our environment for future generations while providing for today's needs. WIN Waste Innovations is a vertically integrated business with a platform of 50 strategically located collection, transfer, and disposal assets. These include waste-to-energy facilities, transfer stations, ash monofills, landfills, and fleets of rail cars and collection vehicles. We process more than 11 million tons of waste annually, converting 6.7 million tons of waste into clean, renewable energy that powers 340,000 homes. We recycle more than 234,000 tons of plastic, paper, and metals from the waste stream.
At WIN Waste Innovations, each eligible employee receives a competitive total compensation package including Medical, Dental, Vision, Life Insurance and Short-Term Disability. As well as Company match on 401K, and more! Our employees also receive Paid Vacation, Holidays, and Personal Days. Please note that benefits may vary by site. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Key Responsibilities:
* Evaluate and verify all claims, including initial intake, investigation, and ongoing case management.
* Develop and implement best practices for claims handling, documentation, and reporting
* Ensure timely and accurate processing of claims, from initial reporting through resolution.
* Investigate and analyze insurance claims to determine coverage, liability, and the extent of damages or losses.
* Conduct interviews with claimants, witnesses, and experts to gather information and assess claims.
* Review policy details, medical records, repair estimates, and other relevant documentation. Support our TPA with the same in subrogation matters.
* Prepare and submit reports on claim status, outcomes, and financial impact to management and other stakeholders, and work to resolve any claims-related issues.
* Maintain up-to-date knowledge of federal, state, and local regulations regarding leaves of absence and workers' compensation.
* Ensure compliance with legal and company policies, including proper documentation and record-keeping and the POC for our DQ and Controlled Substance TPA.
* Maintain detailed records of claims, including notes on investigations, correspondence, status, outcomes, and settlement agreements.
* Maintain confidentiality and accuracy in processing sensitive employee information related to disability and compensation claims.
* Communicate effectively with employees, managers, legal, medical providers, and insurance carriers to gather necessary information and provide updates.
* Analyze trends and data related to claims to identify areas for improvement and ensure effective claims management and generate reports with relevant metrics.
* Serve as the main point of contact between our health partners for claims and employee testing and aid the operations team with annual scheduling.
* Maintain positive work environment by acting and communicating in a manner so that you get along with customers, clients, vendors, co-workers and management.
Who You are:
* Bachelor's degree in business administration, Human Resources, Insurance, or a related field.
* 4+ years of experience in administration of the following areas: Worker's Compensation, Short / Long term disability program preferred
* Knowledge of workers' compensation laws and related regulations is preferred.
* Strong analytical and problem-solving skills.
* Excellent communication and interpersonal abilities.
* Must be organized, process-driven, and can process high levels of detail.
* Must be proficient in Microsoft Office Suite and awareness of claims management software, and/or TPA applications is preferred.
What You'll Enjoy:
* Industry leading benefits
* Multiple and flexible medical plans
* Outstanding PTO program
* Floating Holidays
* Strong 401k program and company match
* Tuition reimbursement plan
* College loan reimbursement
* College scholarship program for dependents
* Parental Leave Program
* Inclusive culture
* Employee engagement events
* Employee resource groups
WIN Waste Innovations is a waste management company committed to delivering essential waste management solutions to customers and communities supported by our team of 2,300 employees. We believe in preserving our environment for future generations while providing for today's needs. WIN Waste Innovations is a vertically integrated business with a platform of 50 strategically located collection, transfer, and disposal assets. These include waste-to-energy facilities, transfer stations, ash monofills, landfills, and fleets of rail cars and collection vehicles. We process more than 11 million tons of waste annually, converting 6.7 million tons of waste into clean, renewable energy that powers 340,000 homes. We recycle more than 234,000 tons of plastic, paper, and metals from the waste stream.
At WIN Waste Innovations, each eligible employee receives a competitive total compensation package including Medical, Dental, Vision, Life Insurance and Short-Term Disability. As well as Company match on 401K, and more! Our employees also receive Paid Vacation, Holidays, and Personal Days. Please note that benefits may vary by site. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
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