Princ Workers Comp Specialist - job 2 of 2

Description

We're powering a cleaner, brighter future.

Exelon is leading the energy transformation, and we're calling all problem solvers, innovators, community builders and change makers. Work with us to deliver solutions that make our diverse cities and communities stronger, healthier and more resilient.

We're powered by purpose-driven people like you who believe in being inclusive and creative, and value safety, innovation, integrity and community service. We are a Fortune 200 company, 19,000 colleagues strong serving more than 10 million customers at six energy companies - Atlantic City Electric (ACE), Baltimore Gas and Electric (BGE), Commonwealth Edison (ComEd), Delmarva Power & Light (DPL), PECO Energy Company (PECO), and Potomac Electric Power Company (Pepco).

In our relentless pursuit of excellence, we elevate diverse voices, fresh perspectives and bold thinking. And since we know transforming the future of energy is hard work, we provide competitive compensation, incentives, excellent benefits and the opportunity to build a rewarding career.

Are you in?

PRIMARY PURPOSE OF POSITION

To protect the Company's assets and self-insured retention ($3 Million) by managing an area(s) of expertise within the workers' compensation group; litigated and non-litigated Workers' Compensation Claims and direct the investigation of large exposure/serious injury cases. Establish appropriate reserves on cases in accordance with established insurance industry standards, practices, and procedures. Analyze liability and evaluate financial risk to the Company on high complexity injury loss. Prepare monthly statistical reports as required.

PRIMARY DUTIES AND ACCOUNTABILITIES

• Supervise the activities of the Claims adjusters assigned by the Third-Party Administrator. Develop defense strategies in litigated and non-litigated matters. Work with Nurse Case Managers in house and vendors to develop initiatives to reduce corporate exposure to liabilities. Direct the field investigation of high-profile workers' compensation claims including possible subrogation potential. Determine liability, analyze losses, and ensure appropriate reserves. Manage the work product and document performance of Claims Adjusters. Negotiate and mediate any Workers' Compensation claim to minimize corporate liability. Initiate innovative Best Practices to reduce costs and company exposure. (20%)
• Prepare written investigation reports, letters, and other documents as necessary. Ensure SOX compliance via proper Reserve Accounting on Claim exposures. Support the loss prevention process (5%)
• Provide educational and informational services to internal and external constituencies. (5%)
• Manage, direct, formulate defense and resolve multi-million-dollar Workers' Compensation cases. Settle Labor cases along with Workers' Compensation cases. Facilitate global settlements and settle employee buyout cases in which Business Unit provides dollar authority to Workers' Compensation in order to obtain full release and resignation. Meet with Petitioners attorney at office or Industrial Commission in order to settle case, with full dollar settlement authority. Decide what cases to take to trial (20%)
• Coordinate and direct OHS and Business Unit on disability cases that have been denied by Workers' Compensation and are being handled under as a short-term disability case. (5%)
• Provide strategy and direction along with dollar settlement authority to adjusters and defense attorneys Provide direction and guidance to Business Unit and HR in returning long term limited (LTL) duty workers back to work, Provide direction and guidance to HR and Business Unit in Workers' Compensation cases involving discipline or termination, Provides advice to Exelon its Executives and Business Units regarding Illinois Workers' Compensation law. (20%)
• Oversee, direct and manage all vendors, adjusters and outside counsel; Authority to order surveillance investigation; Authority to hire vendors: surveillance companies, Nurse Case Manager's, medical equipment and transportation, Ergo Study employers. Contact and speak directly with reporting officers, detectives and our Security Dept in criminal matters involving our employees (15%)
• Meet with family (survivors) of deceased worker as well as their legal counsel, in order to explain family's rights and benefits entitled under Illinois Workers' Compensation law. (5%)
• Authority to change pay codes and credit vacation time back, Responsible for both accounts payable and accounts receivable (subrogation); Authority to request any Company document, medical file, benefit file, personal file, drug and alcohol testing results. Authority to subpoena external documents (5%)

JOB SCOPE

• Reserve and settlement authority of up to $50,000.
• Direct the activities and monitor performance of up to five external Claims associates.
• Works under minimal supervision.

Qualifications

MINIMUM QUALIFICATIONS

• Bachelor's degree and 7-10 years of relevant investigative, Workers' Compensation claims or insurance experience, or in lieu of a bachelor's degree, 9-12 years of relevant experience. Minimum 3 to 5 years prior supervisory experience.
• Knowledge of Workers' Compensation Legal Process,
• Statutes, and Case Law.
• Information Technology skills and knowledge used in the handling of Workers' Compensation claims.
• Self-motivated and ability to handle heavy case load under pressure.
• Excellent written and verbal skills

PREFERRED QUALIFICATIONS