Leave of Absence Specialist
ABOUT US
Fashion Nova is an inclusive fashion-forward and trend-driven apparel and lifestyle brand that celebrates all dimensions of confidence. We use our platform to spread positivity with brands for women, men, curve, luxe, sport, swim, beauty, and kids. We are obsessed with creating the best experience available for our customers and employees.
Fashion Nova was built on the backbone of individuality and inclusiveness. Our brands are worn and celebrated worldwide by customers, celebrities, and influencers because of our uniquely creative and talented employees.
ROLE OVERVIEW
The Manager, Workers' Compensation is responsible for supervising and monitoring Fashion Nova’s Workers’ Compensation program at all company owned and operated locations. The Manager, Workers' Compensation will be responsible for developing and collaborating successful partnerships with our associates, Third-Party Administrators (TPAs), internal stakeholders and service providers.
POSITION IS ONSITE IN SANTA FE SPRINGS | HYBRID|REMOTE WORK IS NOT POSSIBLE
RESPONSIBILITIES
- Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
- Negotiates settlement of claims within designated authority
- Calculates and assigns timely and appropriate reserves to claims
- Manages reserve adequacy throughout the life of the claim, providing Finance with monthly updates
- Prepares necessary state fillings within statutory limits
- Manages the litigation process; ensures timely and cost-effective claims resolution
- Coordinates vendor referrals for additional investigation and/or litigation management
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
- Manages claim recoveries, including but not limited to, subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets
- Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
- Communicates claim activity and processing with the claimant and Leadership; maintains professional client relationships
- Ensures claim files are properly documented and claims coding is correct
- Refers cases as appropriate to supervisor and management
- Partners with multiple departments to coordinate and supervise the Return-to-Work program for team members to ensure work restrictions and transitional work guidelines are being adhered to
- Availability and|or work evenings and weekends as dictated by business needs
ROLE REQUIREMENTS
- Five plus years of experience processing lost time workers’ compensation claims, preferably for an employer with a high-deductible program
- Bachelor’s degree in Business Administration or Finance
- IIA, AIC, AEI, and|or CPCU Designations | Self-Insured Certification highly encouraged
- Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business
- Excellent oral and written communication, including exceptional presentation skills
- Advanced knowledge of Google Suite
- Experience with fraud investigations
- Knowledge of medical terminology
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Fashion Nova, LLC, and subsidiaries thereof, is an Equal Opportunity Employer. We are steadfast in our commitment to equal employment opportunities and pledge that these objectives are reflected in all aspects of our daily operations. We will continue to recruit, hire, train, and advance in employment qualified individuals in all job titles without regard to race, color, national origin, gender, sexual orientation, gender identity, religion, age, status as a protected veteran, criminal history, or status as an individual with a disability; and shall not discriminate against any individual, any such characteristic, nor any other classification protected by local, state and|or federal law.
Create a Job Alert
Interested in building your career at Fashion Nova? Get future opportunities sent straight to your email.
Apply for this job
*
indicates a required field