Job Title: Risk Manager
Education: BA Art History
Previous Experience: I currently do Risk Management consulting helping companies managed the costs associated with workers compensation claims on an hourly basis for a variety of clients. Previous work has been in the Insurance Industry as a Claims Manager, Sr Claims Representative and a Road Adjuster.
Job Tasks: The company is a small consultant firm that provides Risk Management and Medical Management services to a variety of companies that are based in MA. Most of us work from home with some on site client work as needed. We are a certified Utilization Review Provider in MA so we pre-certify medical treatment on Workers Compensation claims as mandated by the WC laws in MA. We assist Third Party Administrators and Insurance companies to cost effectively managed workers compensation claims.
My daily experience is making calls to injured workers and assisting them to the get quality medical attention they need. I also assist the adjuster and employer in the investigation of claims and determination of compensability. I am in communication with the employer, the injured worker, and the medical provider constantly until the claim is resolved. My goal is to coordinate quality medical care so I can facilitate a prompt return to work. I help to identify transitional light duty work and monitor the recuperation until the person is transitioned to full duty. If it is a questionable or litigated claim I assist the adjuster and defense counsel in prepping their case.
I work with a variety of clients from all kinds of industry and services businesses - large retail store chains, small fuel delivery companies, large beverage distributors, to small mom and pop stores. This means on a daily basis I need to effectively communicate with the Customer Service Associate, the fuel driver, the CEO, the line worker, the Human Resources Representative, lawyers, and doctors and nurses.
In my current role I also attend Industrial Accident Board legal proceedings as needed. I advise the client on the law, the exposure of the claim, how it will affect their premium, and provide my thoughts on the most cost effective resolution. I assist in the negotiation of settlements.
Best and Worst Parts of the Job: The best part of this job is helping someone get the medical care they need promptly and efficiently without the stereotypical insurance company hassle or delay. A "thanks, you really helped me out" makes it worth while!
I enjoy the flexibility that working from home three days a week offers me as I have two elementary school age boys that keep me busy!
As I am working as a consultant from home, I do not have to report to an office, dress for work, or deal with a boss hovering over my desk.
The worst part hands down is dealing with incompetent claims adjusters who do not have the courtesy to return phone calls!
I do not care for dealing with the folks that you know are trying to take advantage of the system. I take it too personal when a judge does not see it and awards them money anyhow!
1. Take insurance courses via the Insurance Institute of America
2. Take all free courses your company offers and get licensed in all states
3. Make sure as you move up the ladder you look for ways to broaden your experience. Strive for a balanced background - some liability, some auto, some workers compensation. Look at personal lines and commercial lines as well so you are more marketable as you age.
Additional Thoughts: Return phone calls the day you get them. Keep your promises on your follow up plan and time frame. Keep organized and keep on diary on each claim you are working
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