Sr Claims Rep - Workers Comp

Walt Disney World


Date: 7 hours ago
City: Kissimmee, FL
Contract type: Full time
“We make magic.” That’s our motto at Walt Disney Parks and Resorts and it permeates everything we do. At Disney, you’ll help inspire that magic by enabling our teams to push the limits of entertainment and create the never-before-seen!

What You Will Do:

The qualified candidate will be responsible for the investigation, management, and disposition of Florida workers' compensation claims for the Walt Disney World Resort and affiliated companies. Candidates should be comfortable presenting training and information sessions to an audience and to all levels of leadership across the Resort. The qualified candidate will participate in initiatives to meet the department’s goals. Candidates must be willing to have periodic on-call responsibilities, which in some cases will necessitate responding to incidents after hours.

Required Qualifications & Skills:


  • Florida 6-20 All-Lines Adjuster license in good standing
  • Minimum of 3 years workers compensation claims handling experience, including but not limited to, coverage verification, comprehensive claim investigation, reserve management, benefit payment, compliance, and ongoing communication with and support of injured Cast Members
  • Demonstrated ability to administer litigated claims, including experience in depositions, hearing testimony, mediation, settlement preparation, and comprehensive case evaluation
  • Demonstrated ability to effectively solve problems and make decisions
  • Proven ability to deliver concise and informative written summaries in memo and presentation format, with appropriate business writing and usage of professional grammar
  • Demonstrated ability to prepare and submit excess carrier claims reports and monitor/track reimbursement.
  • Demonstrated ability to administer claims with complex Medicare Set Aside considerations and claims with costly and complex medical treatment
  • Proven ability to communicate and work with all levels of Cast Members
  • Ability to work under deadline pressures and effectively prioritize multiple tasks in a fast-paced environment
  • Demonstrated strong relationship-building, negotiating, and influencing abilities
  • Demonstrated ability to train and mentor claims representatives on all aspects of claims administration
  • Demonstrated ability to handle confidential information
  • Demonstrated strong organizational skills
  • Demonstrated excellent time management skills
  • Demonstrated familiarity with automated claims administration and management systems
  • Demonstrated understanding of medical and legal terminology
  • Ability to complete compliance related claims documentation to support federal and state reporting
  • Computer proficiency within a Windows environment, including Outlook, Word, Excel, PowerPoint, and TEAMS
  • Ability to work in multiple computer programs and in a paperless claims' environment.
  • Lead a project team in support of the department’s business initiatives


Preferred Qualifications:


  • 5 years claims handling experience adjusting Florida Workers' Compensation claims
  • Proven Employer Self-Administered workers' compensation claims handling
  • Board Certification in Workers’ Compensation (CWC)
  • Proven bilingual ability


Education:


  • Bachelor’s degree or equivalent experience

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