Risk Management Coordinator

MERUELO ENTERPRISES, INC

Risk Management Coordinator

SUMMARY

The Risk Management Coordinator position serves to assist risk management. This includes coordination with insurance companies, medical providers, legal representatives as well as general liability and auto claim billing.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Must be able to effectively work with all Team Members at all levels of the organization and offer excellent customer service.
• Retrieve and enter claim data from carrier database into Spectrum and excel loss reports.
• Inputs and updates claim reserves into Spectrum monthly, using carrier data and excel loss reports by the 5th of each month
• Responsible for the administration of first aid medical billing, to include sending billing to Lien on Me for review.
• Enter new claims into Spectrum and update corresponding excel loss report
• Update and maintain notes as team member’s medical status changes into Spectrum and excel loss reports.
• Assist with monthly general liability investigations reports.
• Provide administrative assistance with auto claims and reports.
• Create labels, folders and setup file for newly reported claims.
• Facilitate scheduling medical appointments for injured / ill Team Member including but not limited to restrictions, follow-up, and inquires by Team Members
• Prepare and distribute Modified Alternative Work Agreement (MAWA), when an injured Team Member is released to modified work.

Update and re-distribute MAWA as the team members’ restrictions change

Process general liability and auto claims billing from 3rd party TPA’s including carrier as electronic billing is received. .

EDUCATION and / or EXPERIENCE

Any combination of experience and education that would likely provide the required knowledge and abilities to qualify.

• Two years of increasingly responsible clerical and / or administrative experience
• High school and / or GED equivalent
• Strong Knowledge of claims handling / administration
• Proficient to Expert Excel Skills Required

SKILLS, PHYSICAL REQUIREMENTS & WORKING CONDITIONS

Ability to learn laws and procedures associated with workers’ compensation and make routine decisions on simple cases, based on a defined set of guidelines.

Speak clearly and persuasively in positive or negative situations, listens intently to others and seeks clarification; Provides clear and pleasant responses to inquires regardless of the situation.

Balances team and individual responsibilities; Exhibits objectivity and openness to others’ views; Gives and welcomes feedback;

Contributes to building a positive team spirit; Understands confidentiality and respect for privileged and confidential information and fulfills this requirement at all times in an uncompromising manner.

Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position;

Accepts responsibility for own actions.

Must possess effective communication, organizational and problem solving skills. Ability to apply basic mathematical concepts and calculations.

Understands and has working knowledge of financial and accounting principles. Able to process high volumes with consistency and speed.

Ability to define problems collect data, establish facts and follow instructions. Ability to perform and apply different problem solving techniques, handle internal / external situations and multi-task functions.

To perform this job successfully, an individual should have knowledge of Microsoft Word & Excel; Spectrum software; Internet software.

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 required to sit for extended periods of time and occasionally walk;
• requires eye-hand coordination, use hands hand movement and manual dexterity use hands to finger, handle, or feel; reach with hands and arms;

stoop, kneel, crouch, listen and speak. The employee may occasionally lift and / or move up bend, reach to shoulder level and lift, carrying, pushing and / or pulling up to 25 pounds.

Specific vision abilities required to see in the normal visual range with or without correction; vision sufficient to read computer screens and printed documents.

Specific hearing levels within normal / audio range with or without correction.

Working conditions consist of a temperature controlled office environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Meruelo Enterprises offers a very competitive pay and benefits package including medical, dental, vision, life insurance and 401k.

The above statements are intended to describe the general nature of the work performed by employees assigned to this position.

This description assists in ADA compliance, and is not intended for any other purpose such as compensation. All employees must comply with company policies and applicable laws.

Management retains the right to assign additional duties periodically and the discretion to add or change the duties of this position any time.