Claims & Risk Manager

Overview :

Title of Position : Claims & Risk Manager

Location : Fairless Hills, PA (fully onsite)

Industry Leading Benefits : Medical, Prescription, Dental, Vision, 401K, Pension, Short and Long Term Disability, Life Insurance, Tuition Reimbursement

Silvi Materials is seeking an experienced Claims Manager to spearhead our handling and analysis of both workers compensation and third-party PD / BI claims.

Silvi effectively self-insures its primary insurance lines through a captive insurance program, which means efficient claims management has a direct impact on company performance.

The ideal candidate will have experience with both workers compensation and auto claims in both PA and NJ. This position is not remote and will require to report to the office daily M-F.

The Claims Manager is responsible for driving optimum claims outcomes, supporting operational goals and developing best practices to ensure sustainable success.

What does Silvi Materials offer you, you may ask?

Phenomenal Benefits : Medical, Vision, Dental, Prescription, Vacation, Paid Holidays and so much more!

Your future in mind : With 401(k) (at select locations) and / or pension options. We want all employees to build for a great retirement!

Growth at Silvi Materials : Growth at Silvi Materials : We offer each employee the opportunity to move into any facet of our complex business.

And our tuition reimbursement program is the perfect springboard to help you get there!

So, what does a Silvi Materials Claims & Risk Manager, do? You'll be an integral part of our team :

Responsibilities

File WC and TP Claims with the appropriate carriers and ensure our claims handling partners are aware of initial claims handling strategy.

Develop and maintain a comprehensive claims management processes to ensure consistent and efficient claims handling.

Establish effective relationships with representatives from our carriers, captive, treating doctors, third-party administrators, outside counsel, and insurance brokers to aid a coordinated team approach to claims management.

Understand and apply both New Jersey and Pennsylvania workers compensation regulations to manage strategic decisions with our third-party administrators and outside counsel.

Gather and produce documentation to insurance and legal teams supporting claims in litigation.

Present payment and settlements for approval with recommendations. Generate checks for claims payments as needed or required.

Interpret workers compensation reports and communicate with other departments to ensure doctor recommendations are executed.

Work with providers to ensure proper treatment is given timely.

Create and manage a network of medical locations for employee care.

Submit OSHA logs and MSHA injury information.

Review adjuster performance to ensure best outcomes for Silvi.

Analyze claims data to identify trends and opportunities for cost savings and process improvements.

Other small tasks as needed such as : managing mobile drug testing supplies, auditing reports for accuracy and assisting in projects associated with the safety and environmental departments.

Knowledge, Skills, and Abilities :

Must be an excellent communicator, and comfortable speaking with occupational health clinics, insurance adjusters, legal counsel and all levels within our organization.

Knowledge of Workers’ Compensation insurance coverage, and experience managing WC claims.

Skillful knowledge of claims processing procedures.

Ability to work with persons under adverse or highly emotional conditions.

Ability to work onsite and provide after hours coverage if needed.

Ability to be discrete with information.

Ability to act in a professional and courteous manner.

Very strong computer skills with the ability to master software programs such as excel, medical portals, KPA EHS, Lumimos and Risx-Facs.

Ability to manage multiple project simultaneously.

Must be sensitive of and comply with HIPAA regulations.

Qualifications Required

Bachelor’s degree in business, finance, risk management, insurance management or a related field preferred.

Minimum 5 years' experience in managing PD and BI claims in both the auto and general liability space.

Minimum 5 years’ experience in managing workers compensation claims.

Solid background in coverage analysis, reserving, claims investigation and litigation management.

Experience with handling legal documents and interfacing with corporate and external counsel.

Strong knowledge of claims handling best practices and industry regulations.

Excellent analytical, problem-solving, and decision-making skills.

Exceptional communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.

Proficiency in claims management software and Microsoft Office Suite.

Physical Demands

In a typical work setting, people in this job :

Lift up to 20 pounds.

Use one or two hands to grasp, move, or assemble objects

Stand for long periods of time.

Kneel, stoop, crouch, bend, stretch, twist or crawl.

Hear sounds and recognize the difference between them.

See details of objects that are less than a few feet away.

See differences between colors, shades, and brightness.

Silvi Materials does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors.