Leave of Absence and Workers Comp Specialist

Responsibilities

• Investigates employee incidents in collaboration with the Employee Health Department and Department Managers so corrective action can be taken if appropriate and reoccurrence of risk can be reduced.
• Administers Leave of Absence (LOA) programs, including FMLA and ADA, in accordance with State and Federal Guidelines and MyMichigan Health’s policies. Updates LOA and ADA policies as needed.
• Directs employees on Workers Compensation claims process. Administers LOA program for assigned subsidiaries. Enters FMLA and non FMLA applications into Infor medical leave for hours used and medical documentation needed. Enters information on leaves of absence into Infor. Communicates to managers and HR on leave status of employees. Communicates medical information to appropriate department for Short Term Disability (STD) pay. Reviews and approves STD report prior to report going to pay management. Prepares and sends appropriate communication and paperwork to employees, managers and other affected individuals in a timely manner and as required by law or policy.
• Exchanges information with Third Party Administration (TPA) and nurse case managers so that claim is processed within the legal requirements. Makes recommendations/directing TPA and nurse case managers in handling Workers Compensation claims.
• Leads and Administers ADA program for assigned affiliates. Determines if there is an ADA request and initiates the interactive process. Notifies manager and other key people as to request for ADA accommodation. Leads the interactive process between employee, manager and Human Resources representative, if needed, for determining ADA accommodations. Documents and communicates outcomes of the process to appropriate personnel in a timely manner and as required by law or policy.
• Under the guidance of the Senior Workers Compensation Specialist approves/denies recommendations from TPA such as Independent Medical Exam (IME), surveillance, medical management, Voc Rehab, outplacement, etc. Collaborates with other system leave specialists, Human Resources (HR) and other system team members for FMLA and ADA policies and procedures as well as case management.
• Actively participates in teams, groups and meetings.

Qualifications

• Three years’ experience working within human resources, benefits and/or leaves of absence and disability management preferred.
• A Certified Worker's Comp Professional Certificate preferred.
• Previous FMLA and ADA Experience Is Preferred.
• Working knowledge of office and insurance/billing/policies, practices and procedures acquired through 5 years’ experience in a healthcare environment is preferred.
• Thorough knowledge of computerized incident and claims software including report creation and generation and working knowledge of Internet for research purposes are both preferred.
• Problem solving techniques/expertise; Excellent human relations, customer service and communication skills are required.
• Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to articulate ideas and concepts in a clear and understandable manner are required.
• Mandatory Occupational Safety and Health Administration (OSHA) training must be completed annually according to the Exposure Control Plan.
• Working knowledge of State and Federal FMLA, ADA, Health Insurance Portability and Accountability Act (HIPAA) and related regulations is required.
• Must uphold the highest level of confidentiality.
• Knowledge of medical terminology is preferred.
• Experience with Infor database development and management, as well as Excel report writing, is preferred.