Workers' Compensation Specialist

About the role

Performs the full range of professional duties required to administer and oversee the workers' compensation program, including the performance of complex and/or sensitive claims activities; provides guidance on claims administration, medical case management, and return-to-work coordination; monitors legislative compliance and third-party administrator performance; recommends and implements changes in program practices, workflows, policies, and procedures; audits claims and analyzes program data to support regulatory filings and fiscal performance; participates in procurement and contract administration; collaborates with internal and external partners to resolve complex claims issues; provides guidance and professional development to staff; may manage large-scale, long-term projects.

Responsibilities

• Performs activities related to the administration and management of the division-wide workers' compensation program.
• Responsible for workers' compensation claims administration, including medical case management, return-to-work coordination, and disability management activities.
• Documents and resolve complex and/or sensitive workers' compensation issues in collaboration with employees, internal staff, the third-party administrator (TPA), and other external partners.
• Ensures compliance with federal and state laws and regulations and School Board policies related to workers' compensation.
• Researches industry best practices and trends related to workers' compensation, claims management, cost containment, and return-to-work programs.
• Works as a team member and/or leader in developing recommendations on programming, workflows, policies, procedures, and internal controls.
• Documents, implements, and monitors changes to workers' compensation programs and business processes.