Morgan Consulting Resources is an executive search firm focusing on the Healthcare Industry for 15 years. We have extensive experience in bringing together leadership talent with organizations that cover all aspects of Healthcare Services – Providers, Payers and Supporting Service organizations. We have been retained by a workers compensation medical bill review corporation to conduct a search for an Account Executive. This position will be located in Naperville, IL.

This nationwide company was formed in 1995 and have been growing rapidly. By focusing on medical bill review, they are able to leverage their experience and expertise to provide the best possible service and savings for their clients. They utilize the Ingenix PowerTrak system and their clients include insurers, large self-insured employers, TPAs and municipalities.

The Account Executive reports to the President. The department consists of one other Account Executive, an Account Manager and administrative support. Our client is looking for a dynamic individual, focused on business growth and retention. The candidate we seek will be a high energy, enthusiastic sales person with the skills of a competitive self-starter. A track record in achieving significant sales growth and excellent relationship building skills are a must. We are looking for someone with at least 3 years of workers’ compensation sales experience in any one of various sectors including: bill review, care management, PPO, etc.

The company offers a strong salary, commission and benefit package as well as a supportive culture that has led to long term employees in this entrepreneurial environment.

If interested, please contact Rosie Saenz at rosie@morganconsulting.com.

Our client provides insurance protection for auto, home, and businesses. They service the states of Illinois, Wisconsin, Indiana and Missouri with a reputation and financial stability obtained through over 100 years of business. They currently offer an opportunity to join their organization in a Senior Claims Examiner role. Our client will begin offering work comp coverage this summer, and they need to hire a workers compensation claims professional to set up a work comp claims unit, be the sole staffing for that unit until premium growth/claims growth occurs enough to have the unit grow. In other words, they need someone to have a hands-on approach initially, but with the skill set to become the unit supervisor/manager in the near future.

Sr. Claims Examiner Qualifications:

Three to four years of multi-line p/c claims handling experience with three to four years of multiple states work comp claims handling experience (They will be writing in IL, IN, WI, & MO).
Supervisory/management aptitude and ambition.

Please contact Scot Dickerson for immediate confidential consideration and additional details. Email: sdickerson@insurance-csg.com Phone: 515-987-0242 ext 18. See our website at, www.csgrecruiting.com/ins_opportunities.htm for a complete listing of nationwide opportunities.

Capstone Insurance Search Group is a search firm dedicated to the insurance industry. We work nationally with expertise that spans top executives, middle management and technical level positions. We can provide assistance with a variety of product lines to include Property and Casualty, Life, Health, Disability, Annuity and Pension. We will provide you with a service that is of the highest degree of confidentiality, professionalism and integrity.

A national insurance carrier is seeking an insurance professional who will be to manage claim operations. The ideal candidate will be responsible for the regional day-to-day claim operation including staffing and development and claims process and procedures to ensure that claim handling is consistent with Company’s best practices.

RESPONSIBILITIES

• Establishes branch claim office objectives supportive of Home Office and Corporate objectives.
• Monitors operations and staff and recommends, when necessary, changes in methods, procedures, structure, and additions or changes in personnel to secure optimum utilization of resources.
• Reviews, analyzes, and gives directives concerning new claim files and assigns or reassigns files to appropriate claim associates or independent adjusters.
• Approves reserve recommendations, establishes reserves and makes recommendations on reserves exceeding authority; analyzes and reviews on a continual basis, the reserve adequacy of a sampling of open claim files to ensure exposure is properly reflected.
• Counsels, advises and provides guidance to all Claim co-workers on accident reports or files to decide questions on coverage, law, liability and value to assure the proper investigation and timely equitable disposition of difficult cases.
• Provides guidance in the negotiation of claims and extends settlement authority to the claim technical staff.
• Monitors department productivity, reports on trends and recommends and implements changes to continually improve work productivity.
• Assists in the selection of approved defense attorneys, medical examiners, independent adjusters, experts, rehabilitation providers, and other vendors. Consults with Home Office on attorney and other vendor selections.
• Identifies, recruits and hires qualified staff.

QUALIFICATIONS

• 5+ years claims management experience within a property and casualty company and/or third party administrator.
• Experience in workers compensation line of business.
• Previous experience in overseeing claims operations at the regional and/or branch level.
• BS Degree.
• Excellent written and verbal communication skills
• Ability to identify and resolve problems in a timely manner, gather and analyze information skillfully.
• Ability to demonstrate accuracy and thoroughness, monitor own work to ensure quality and apply feedback to improve performance.
• Computer skills (Microsoft applications)

About The Regent Group

The Regent Group is a recognized leader in executive search and professional staffing for companies involved in the assessment, management and transfer of risk. Our consultants have extensive backgrounds both in executive search and in serving the needs of the insurance and risk management industries, as well as specific knowledge of the unique issues and trends facing our clients.

We have worked extensively with companies of all sizes, at all stages of the corporate life cycle from startups to runoffs and with all forms of ownership from privately held to mutual owned and publicly traded. Our ability to serve the complex needs of our clients derives from understanding their business from a senior management perspective as an insider, not an outsider.

Visit us online at www.theregentgroup.com

Job Description

The S&H Nurse Consultant manages and coordinates claimant/client needs related to the medical management of worker’s compensation, major health, telephonic, long and short term disability cases via telephonic and/or in-person contact with all parties involved in the claimant’s treatment and rehabilitative process. S&H Nurse Consultants employ the essential activities of case management, including assessment, planning, coordination, implementation, evaluation, monitoring, outcomes management and applying general case management principles. These essential activities are applied within the continuum of care, matching the needs of the claimant/client receiving services, and involve coordination with physicians, family members, payer sources, employers, and other health care providers within the health care system.

The S&H Nurse Consultant is assigned a caseload, based not only on numbers of cases, but on acuity as well. This position is field based.

Skills

Spanish bilingual a HUGE plus!! As S&H is paperless, must be able to utilize a computer. CCM certification or willingness to seek certification within first year of employment. Excellent verbal and written communication skills. Valid drivers license, as you will travel by vehicle to perform on-site medical CM activities. Effectively incorporate the concept of evidence-based medicine into day to day completion of CM activities.

Company Description

S&H is a growing, regional, URAC accredited and WBE certified case management company based out of Chicago and St. Louis, MO. Please email your resume and a copy of your credentials to: resumes@SandHmms.com

Claims Supervisor I – Workers’ Compensation

CLAIM YOUR FUTURE AS A GREAT PERFORMER!

Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and “Claim Your Future.”

PRIMARY PURPOSE: To supervise claims examiners processing claims for a single product line for clients; to monitor colleagues’ workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Supervises claims examiners processing claims for a single product line.
• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews and analyzes management reports and takes appropriate action.
• Performs quality review on disability claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as second level of appeal for client and employees issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
• Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
• Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
• Maintains a quality assurance program to support the total performance management initiative and the consistent delivery of quality claims service.

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS

Education & Licensing

Baccalaureate degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

Experience

Six(6) years claims management experience required.

Skills & Knowledge

• Good technical knowledge of claims management
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Leadership/management/motivational skills
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

Additional Information: Position can be located in either Schaumburg, IL or Chicago, IL office.

Apply Here

Growing Pharmacy Benefit Management Company, focused on the Workers’ Comp and Auto PIP markets, offers tremendous growth and economic opportunities for qualified individual to service customers in your multi-state territory.

Work from home position. Territory is IL, IA, MO, WI, MN, ND, SD, KS, NE.

Travel in your territory up to 75% of the time with 60% overnight travel required.

You may reside anywhere within your territory as long as you have convenient access to an airport.

What you will need for this position:

• 5+ years of sales experience in the Workers’ Compensation market selling directly to Insurance Carriers, TPAs, or Self-Insured Companies.
• Bachelor’s degree
• Experience in the W/C PBM, Risk Management or UR segment is a plus.
• Strong written and verbal communication skills
• History of generating leads, qualifying prospects, preparing and delivering powerful presentations, and closing sales.
• MUST be a self-starter with a home office

What you will be doing:

• Call on, cultivate, and contract companies that are Worker Compensation Insurance Carriers, TPAs, or Self-Insured Companies for their pharmacy and DME business.
• Ability, experience, and knowledge to substantially grow sales in your geographic territory by identifying new opportunities within the existing market and following up on leads provided by the National Sales Manager.
• Sell Prescription Drug Cost Containment Solutions to Workers’ Compensation and Auto Insurance Carriers, self insured employers and TPA’s.
• You will be provided with target accounts in the geographic area where you will be working.
• The expectation is that you will substantially grow sales in your territory by pursuing the target accounts and identifying and pursuing new accounts within the region.

Salary: $70,000.00 to $80,000.00/year

Apply Here

Position: Associate Attorney

Message from Steve Murdock (Partner at Inman & Fitzgibbons, Ltd):

Our well-respected Illinois defense firm is currently seeking an Associate Attorney with 1-4 years of experience in Illinois Workers’ Compensation and/or General Liability to handle defense of workers’ compensation cases. We offer a competitive salary and benefits package along with a well-qualified and respected team of attorneys and staff.

If you are interested, please submit a resume, a list of references and two writing samples to my attention by mail or email.

Mailing Address:

Inman & Fitzgibbons, Ltd.
33 North Dearborn Street
Suite 1825
Chicago IL 60602

Know of anyone else hiring workers’ comp related professionals in Illinois? Let us know!