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Area Manager

Job Details

Management
Milwaukee - Waukesha, WI
Fully Remote
Full Time
High School Diploma or GED
$105,000.00 - $155,000.00 Salary/year
20%
Day
Insurance

Area Manager

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This position can be remote or in office if you are close to one of our TRISTAR offices.  This position will require 10-20% travel.

 

 

POSITIONS SUPERVISED: Directly: Claims Managers/Supervisors; Indirectly:  All positions under the supervisory level including Claims Examiners, Claims Assistants and support staff.

 

 

POSITION SUMMARY:  Under minimal supervision directs overall operations of Branch Office which includes managing staff and supervisors in all aspects of their technical performance and compliance with TRISTAR policies and procedures and operating within established financial restraints. Maintains effective communication with clients to ensure contract compliance and provide excellent customer service.

 

 

DUTIES AND RESPONSIBILITIES:

• Responsible for the overall operation of the office.*

• Develops and maintains strong working relationships with client in order to ensure their

  client servicing expectations and/or needs are being met.*

• Manages the claims staff to ensure compliance with client contracts.*

• Ensures compliance with corporate and client guidelines regarding claims handling

  procedures.*

• Actively participates in the preparation of an annual budget and manage branch

  operations within such budgeted financial restraints.*

• Prepares quarterly operational reports for Home Office commenting on budget

  compliance and productivity.*

• Prepares and ensures distribution of standard monthly reports.*

• Provides ad hoc reports, as may be required, at client’s request.*

• Coordinates and prepares for internal and external audits.*

• Responds to audit reviews and develop and implement corrective action plans as may

  be required.*

• Oversees supervisor work product and diary compliance.*

• Monitors client trust accounts for funding adequacy.*

• Responsible for all personnel actions including hiring, performance reviews, corrective

  action plans and terminations.

• Coordinates information flow, as necessary, to Home Office departments, such as, I.T.,

  Human Resources, Accounting and Sales.

• Conducts regular staff training sessions as may be required, independently, and/or as

  directed by Home Office.*

• Assists Home Office and sales/service team with RFP’s, client service issues or new

  client presentations.

• Maintains visibility in the industry by supporting and attending industry sponsored

  functions, speaking engagements and educational / teaching opportunities.

• Manages office functions that support claims administration.

• Specific responsibilities for the clients to include monthly monitoring of client service and   account management

 

HR duties

 

 

 

*Annual staff reviews; Penalty log; Interviews

Complaints

 

 

 

*Employees, providers, vendors, etc

State/Insurance dept.  Inquiries

 

 

 

Bill Review Audit

 

 

 

*Medical bill processing by adjusters

Claim Audit Responses

 

 

Monthly staff training and development

  

 

Client  Meetings

 

 

*Claim reviews, Program reviews and Improvement

Office Supplies (Mail, copier, etc.)

 

 

 

Conversion discrepancies

 

 

 

*Vendor payments, legal bills,

 

Funds Management Adjustments

 

Vendor Management. Use of Strategic Business Partners

 

 
   

 
 

 

Daily Check Register

  

 

Diaries for over $250,000 (excess & incurred)

QA & Performance Based Oversight Compliance Reviews

Complex Claim Reviews

 

 

 

Qualifications

QUALIFICATIONS REQUIRED:

 

Education/Experience:  Bachelor’s degree in related field (preferred); ten (10) years related experience in managing/supervising workers compensation claims; or equivalent combination of education and experience. 

 

Knowledge, Skills and Abilities:         

  • Exceptionally strong technical claims handling skills and knowledge of workers’ compensation laws.
  • Experience in supervising claims operations.
  • Ability to prioritize multiple tasks and meet strict deadlines.
  • Experience with, or the ability to quickly grasp, the financial issues involved in operating a branch office.
  • Computer literacy in Word, Excel and PowerPoint and claims information systems.
  • Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
  • Ability to read, analyze and interpret claims loss reports.
  • Effectively present information and respond to questions from corporate office, clients, vendors, and staff.
  • Ability to manage diverse staff..

 

Here are some of the benefits you can enjoy in this role:

  • Medical, Dental, Vision Insurance
  • Life & Disability Insurance
  • 401(k) plan
  • Paid holidays
  • Paid time off
  • Referral bonus
 

                             MENTAL AND PHYSICAL REQUIREMENTS

1.  MENTAL EFFORT

 

a.       Reasoning development::

 

          Follow one- or two-step instructions; routine, repetitive task.

 

          Carry out detail but uninvolved written or verbal instructions; deal with a few concrete

          variables.

 

          Follow written, verbal, or diagrammatic instructions, several concrete variables.

 

          Solve practical problems; variety of variables with limited standardization; interpret instructions.

 

 X      Logical or scientific thinking to solve problems; several abstract and concrete variables.

 

          Wide range of intellectual and practical problems; comprehend most obscure concepts.

b.       Mathematical development:

 

          Simple additional and subtraction; copying figures, counting, and recording.

 

          Add, subtract, multiply, and divide whole numbers.

 

 X      Arithmetic calculations involving fractions, decimals, and percentages.

 

          Arithmetic, algebraic, and geometric calculations.

 

__      Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

 

          Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; requires theoretical application.

c.       Language development:

 

          Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

 

          Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

 

          Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

 

          Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

 

 X       Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

2.  PHYSICAL EFFORT

 

a.       Physical activity required to perform the job:

 

          Sedentary work:  Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time.  Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

 

 X      Light work:

a.    Exerting up to 20 pounds of force occasionally

b.    Exerting up to 10 pounds frequently

c.    Exerting a negligible amount of force constantly to move objects

 

          (If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).

 

          Medium work:

a.    Exerting up to 50 pounds of force occasionally

b.    Exerting up to 20 pounds of force frequently

c.    Exerting up to 10 pounds of force constantly to move objects

 

          Heavy work:

a.    Exerting up to 100 pounds of force occasionally

b.    Exerting up to 50 pounds of force frequently

c.    Exerting up to 20 pounds of force constantly to move objects

 

          Very heavy work:

a.    Exerting in excess of 100 pounds of force occasionally

b.    Exerting in excess of 50 pounds of force constantly to move objects

c.    Exerting in excess of 20 pounds of force constantly to move objects

 

    

  1. Visual requirements necessary to perform the job:

 

           Far vision:  clarity of vision at 20 feet or more

 

 X       Near vision:  clarity of vision at 20 inches or less

 

 X       Mid-range vision:  clarity of vision at distances of more than 20 inches and less than 20 feet

 

           Depth perception:  the ability to judge distance and space relationships, so as to see objects where and as they actually are

 

           Color vision:  ability to identify and distinguish colors

 

           Field of vision:  ability to observe an area up or down or to the right or left while eyes are fixed on a given point

 

 

2.  PHYSICAL EFFORT (cont.)

    FREQUENCY

c.    Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):

 

      Climbing:        Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms.  Body agility is emphasized.  This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.

 

      Balancing:       Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces.  This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.

 

 X    Stooping:       Bending body downward and forward by bending spine at the waist.  This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.

 

 X    Kneeling:       Bending legs at knee to come to a rest on knee or knees.

 

 X    Crouching:    Bending the body downward and forward by bending legs and spine.

 

       Crawling:      Moving about on hands and knees or hands and feet.

 

 X    Reaching:      Extending hand(s) and arm(s) in any direction.

 

 X   Standing:        Particularly for sustained periods of time.

 

 X    Walking:       Moving about on foot to accomplish tasks, particularly for long distances.

 

 X    Pushing:        Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.

 

 X    Pulling:         Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.

 

        Foot

       Motion:          Using feet to push pedals.

 

 X    Lifting:          Raising objects from a lower to a higher position or moving objects horizontally from position to position.  This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.

 

 X    Fingering:     Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.

 

 X    Grasping:      Applying pressure to an object with the fingers and palm.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Occasionally

 

 

 

Occasionally

 

Occasionally

 

 

 

Occasionally

 

Occasionally

 

Occasionally

 

Occasionally

 

 

Occasionally

 

 

 

 

 

Frequently

 

 

 

 

Frequently

 

 

Occasionally

 

 

 

 

2.  PHYSICAL EFFORT (cont.)                  

      FREQUENCY

 X   Talking:          Expressing or exchanging ideas by means of the spoken word.  Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.

 

 X   Hearing:         Perceiving the nature of sounds with or without correction.  Ability to receive detailed information through verbal communication and to make fine discriminations in sound, such as when making find adjustments on machined parts.

 

      Feeling:           Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.

 

 X   Repetitive       Substantial movements (motions) of the wrists, hands,

      Motion:          and/or fingers.

Frequently

 

 

 

Frequently

 

 

 

 

 

 

 

Frequently

 

 

3.  WORKING CONDITIONS

 

Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure. 

 

       WORKING CONDITION

           ENVIRONMENTAL

                     FACTOR

           NATURE/REASON

               OF EXPOSURE

 

                FREQUENCY

Dirt/Dust

 

 

Noise

 

 

Temperature extremes

 

 

Dampness

 

 

Vibrations

 

 

Equipment movement hazard

 

 

Chemicals/solvents

 

 

Electrical shock

 

 

Significant work pace/pressure

 

 

Odors/Fumes

 

 

Other (specify):                              

 

                                                         

 

 
       

 

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