UNIV - Workers’ Compensation Coordinator - Department of Insurance Services

About the role

The purpose of this position is to provide technical and professional services to the Workers’ Compensation Division of the Office of Insurance Services. Assist in processing and monitoring injury cases for employees of MUSC, MUHA Charleston and/or MUHA regional hospitals which includes but is not limited to, assisting employees who have sustained a work- related injury through submission of a claim to our insurance carrier or through management of self-insured claims. Provide technical and professional assistance (for insured and self-insured claims) from notification of potential claim to closure. Coordinate billing of MUSC and MUHA self-insured claims. Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in injury databases/claims management system as required by regulatory bodies and for analysis and dashboard reporting for MUSC and/or MUSC Health System and in support of the Insurance Services shared service agreements. Serve on various committees as needed.

Responsibilities

• Assist in processing and monitoring of assigned MUSC and /or MUHA injury claims, including insured and self-insured claims, from notification of potential claim until closure of claim.
• Provide technical and professional assistance in case management, transition back to work assistance, claim investigations, and settlements.
• Schedule appointments, obtain current medical information, and assist the injured employee by providing a liaison with a State Accident Fund (SAF) adjuster and/or nurse case management vendor.
• Submit timely acknowledgments of new injury reports to injured Care Team Member and Manager as appropriate.
• Facilitate transition back to work initiatives for injured workers to include assisting managers and coordinating alternative assignments or modified duty assignments when appropriate.
• Ensure continued communication with injured worker, manager of injured worker, HR, EHS, SAF, and nurse case management vendor.
• Respond promptly to inquiries from injured worker, manager of injured worker, EHS, HR, SAF, and nurse case management vendor.
• As directed, act as MUSC/MUHA representative for depositions, conferences, mediations, or hearings, working with assigned attorneys, employees, and carrier representatives, as necessary.
• Maintain all assigned MUSC and MUHA Injury data as required by regulatory bodies such as OSHA and Joint Commission.
• Prepare and manage OSHA Logs.
• Manage database of modified duty assignments.
• Manage database of charges for analysis and prepare reports as requested.
• Prepare injury-related reports at required intervals as requested by leadership for various organizations and departments.
• Coordinate billing of all MUSC and MUHA self-insured workplace injury claims.
• Respond to facility, physician, and pharmacy internal billing representatives regarding billing.
• Ensure accurate invoicing and payment based on current workers’ compensation payment schedules for facility, physician, and pharmacy charges.
• Prepare and submit bills for processing in a timely manner.
• Provide continuous support of aforementioned duties to MUHA Regional Health Network hospitals as needed.
• Affiliate Support 5%
• Assist in ensuring out-of-state, remote workers are adequately insured and claims managed.
• Other duties as required.

Qualifications

• A bachelor's degree and two years relevant program experience.

Physical Requirements

• Ability to perform job functions in an upright position.
• Ability to perform job functions in a seated position.
• Ability to perform job functions while walking/mobile.
• Ability to work indoors.
• Ability to work outdoors in all weather and temperature extremes.
• Ability to work in confined/cramped spaces.
• Ability to perform job functions from kneeling positions.
• Ability to squat and perform job functions.
• Ability to perform 'pinching' operations.
• Ability to fully use both hands/arms.
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders.
• Ability to reach in all directions.
• Possess good finger dexterity.
• Ability to maintain tactile sensory functions.
• Ability to lift and carry 15 lbs., unassisted.
• Ability to lower objects, up to 15 lbs., from height of 36 inches to floor level, unassisted.
• Ability to push/pull objects, up to 15 lbs., unassisted.
• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes.
• Ability to see and recognize objects close at hand.
• Ability to see and recognize objects at a distance.
• Ability to determine distance/relationship between objects; depth perception.
• Good peripheral vision capabilities.
• Ability to maintain hearing acuity, with correction.
• Ability to perform gross motor functions with frequent fine motor movements.

Benefits

This position is considered an essential position. The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.