Company Details: Preferred Employers Insurance Company began operations in San Diego, California in 1998.
The company provides workers’ compensation insurance for a wide variety of industries.
Our goal is to provide our customers with a stable and reliable workers’ compensation insurance product regardless of market cycles.
We are dedicated to being the preferred workers’ compensation insurance solution for California businesses.
Responsibilities: The Claims Regulatory Reporting Specialist reports to the Claims Operations Manager and is responsible for the timely and accurate preparation and filing of various WCIRB and WCIS related regulatory reports in compliance with all legal and regulatory requirements as well as company policies, procedures, best practices and standards of conduct.
The Claims Regulatory Reporting Specialist will adopt consolidated and harmonized sets of controls to ensure that we comply with all relevant laws, policies, and regulations and that these requirements can be met without the unnecessary duplication of effort and activity from other units and departments.
This position will act as designated team member on all Claims regulatory reporting including Unit Statistical Reporting (USR), First Report of Injury (FROI), Subsequent report of Injury (SROI) and Centers for Medicare and Medicaid Services (CMS).
The Claims Regulatory Reporting Specialist will also perform Claims related perform financial tasks such as processing returned checks, unclaimed property, refunds, subrogation and joint coverage checks.
The Claims Regulatory Reporting Specialist must be a team player, able to recognize and communicate problems early and suggest effective solutions.
This position requires particular attention to detail and ability to reprioritize and demonstrated leadership skills.
Key functions include but are not limited to the following:Model all core company values, compliance policies and guidelines.Assist in identifying areas of compliance vulnerability and risk and developing new workflows to strengthen them.Run weekly and monthly FROI, SROI acceptance and error reports from our WCIS EDI partner portal.Submit FROI and SROI reports as requested.Assign FROI and SROI errors to Support Unit team members and ensure they are corrected in a timely manner.Process and correct monthly USR submission report errors in a timely manner.Work with SeniorClaims Operations Manager, AVP of Medical and others as appropriate to develop an effective regulatory reporting including appropriate introductory training for new Claims employees as well as ongoing training for all existing Claims employees and managers.
Qualifications: 10 years of related administrative office work experience or 5 years of Workers’ Compensation Claims Assistant experience preferred.Ability to reprioritize tasks and meet strict deadlines.Strong written and verbal communication skills and attention to detail.Ability to train team member and new hires on compliance procedures.Demonstrated leadership abilities.Ability to work in a fast paced environment both independently and collaboratively with all levels of staff.Goal oriented and outcome focused.Ability to work under pressure to create accurate reports and documentation.Proficient with MS Office software and PC applications and systems.
Additional Company Details: The Company is an equal employment opportunity employer.
Additional Requirements: COVID-19 vaccine required unless prohibited by law.