Description Kforce has a client in search of a Workers Compensation Manager in Stamford, Connecticut (CT). Essential Duties and Functions: Responsibility for oversight of Clients Workers Compensation Program Responsible for building consensus and managing risk to the Client Responsible for building, maintaining, and managing relationships with claims adjusters, insurers, legal counsel, and other claims related parties Responsibilities include claims monitoring, providing direction to TPA Management, and communicating with employees, Managers, Insurance Carriers, Doctors, internal and external counsels, and medical networks; responds to questions and issues Reviews first reports of injury for red flags, correct coding of injury type, body part, etc.; Advises adjusters of any needed corrections or feedback Reviews TPA initial investigation results and provides feedback and direction to adjuster as necessary Ultimate decision maker on questionable claim approvals and on all denials, relying primarily on experience and complexity of each case; Consults with Director and legal counsel as necessary Works with TPA and legal counsel to ensure timely processing and management of claims; Oversees work of TPA, external legal counsel, and others involved with each case, and provides direction as necessary Authorizes nurse case management when applicable Authorizes special investigation, including surveillance, when applicable Reviews and authorizes changes in case reserves and settlement amounts as requested by adjuster in accordance with the Client's special account instructions Oversees activities of external workers compensation attorney for cases involving litigation Works with TPA and legal counsel to identify claims appropriate for full and final settlement; Provide recommendation to Director and, as necessary, the Office of the General Counsel Requirements 10 years of experience adjusting or managing workers compensation claims Kforce is an Equal Opportunity\/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
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