Job Summary: Perform general administrative support and coordination activities for workers compensation program and injured workers claims management.
Ensure employees receive the support they need during recovery, and to minimize the financial impact on the organization.
Effective coordination of workers’ compensation claims is essential for both employee well-being and the Company’s compliance and cost management.
Essential Responsibilities/Activities:
Process and verify accuracy of workers compensation claims, incidents, or occurrences according to established regulatory standards, procedures, and guidelines.
Receive and document workers’ compensation claims from injured or ill employees.
Manage the entire claims process, from initial intake to resolution.
This includes ensuring that all required documentation is complete and accurate, submitting claims to the insurance carrier, and tracking the progress of claims.
Point of contact between injured employees, medical providers, insurance companies, and other relevant parties.
Provide clear and timely communication to all stakeholders throughout the claims process.
Provide education and information to employees about the workers’ compensation process, their rights, and the benefits available to them.
Maintain organized and confidential records of all workers’ compensation claims, including medical records, incident reports, claim status updates, and correspondence.
Collaborate with the injured employee and medical professionals to facilitate a safe and timely return to work.
Develop and implement return-to-work programs that help injured employees transition back to work safely and efficiently while accommodating any temporary work restrictions.
Produce reports of incidents and workers’ compensation claims trends, costs, and outcomes for management review and analysis.
Resolve disputes or disagreements related to workers’ compensation claims, which may involve mediation or attending hearings.
Prepare monthly payroll reporting to insurance carrier.
Report midyear self-audit information to insurance carriers.
Work with insurance carriers on annual workers compensation policy audits.
Education and Experience Requirements:
Degree(s): High school diploma or equivalent and previous experience working in HR or similar environment preferred.
Previous experience with insurance claims processing a plus.
Essential Mental Functions:
Strong organizational skills and attention to detail.
Basic computer skills and experience with documentation.
Excellent communication and interpersonal skills.
Knowledge of state and federal law and regulations related to workers compensation.
Ability to work independently and manage multiple priorities in a fast paced environment.
Essential Physical Functions:
Ability to sit and stand for extended periods of time.
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