Workers Compensation Specialist

About the role

The Workers’ Compensation Specialist will facilitate and direct all Workers’ Compensation processes in accordance with established Legal Risk Department and Industry Recommended Practices.

Responsibilities

• Assure each Providence Affiliated Facility has access to all Recommended Employee Safety and Workers Compensation Programs and they understand how to properly apply:
  • Internal Claims investigation
  • Accurate and timely Claims Reporting
  • First Aid and Triage
  • Transportation to MPN and RTW programs
• Initiate contact with injured employees and explain the Workers’ Compensation process as it relates to the injured employee
• Provide an overview of the Insurance Company, Employee’s Physician, Employer and the Wellness Manager’s roles during the recovery
• Incorporate all claim information into the Claim File
• Accurately and completely document conversations and maintain an accurate electronic file of communication related to the injured employee’s Workers’ Compensation claim
• Assure report claim information and injury reports are accurately and promptly referred to the appropriate insurance carrier
• Work as professional liaison between operations and claims adjuster
• Assure each facility maintains contacts with treating physician after injured employee’s visit obtain work restrictions and information on injured employee’s condition and treatment plan
• Measure and report compliance of clinics with our recommended protocols
• Remain in contact with the injured employee and gather information on the status of the injured employee’s health condition
• Consult with the employee’s physician, nurse case manager, claims adjuster, and project staff to determine if the injured employee is following the treatment plan prescribed by the employee’s physician
• Act as a liaison between the injured employee’s physician, insurance company, nurse case manager, management, and employee to gain a timely return-to-work release
• Maintain communication with the insurance carrier; prepare status reports on critical claims for management
• Ability to track the status of assigned claims to their successful and timely completion required
• Ability to organize and prioritize a heavy workload to meet deadlines required
• Must be trustworthy and can handle highly confidential information with the utmost care and discretion required
• Work with Broker and Insurer to produce monthly claims reports to Operations
• Direct monthly internal calls with Facility management
• Quarterly claims reviews with Insurer
• Work as Consultant to HR and other PACS staff
• Develop and assist in implementation of Risk Avoidance Programs as necessary
• Accept other assignments as needed
• Some overnight travel required

Supervisory Requirements

This position has no direct supervisory responsibilities but does serve as a coach and mentor for other positions within the company.

Qualifications

• Bachelor's degree (B.A.) from a four-year college or university
• Travel by auto or airline will be required 25% of the time
• In the office, or remote position, flextime available to work from home

Physical Demands

• Ability to spend prolonged periods of time standing, speaking, walking, driving, and/or sitting
• Requires ability to occasionally lift up-to 25lbs
• Position may require travel: Up to 80% of the time to facility sites
• Reasonable accommodation may be made to enable individuals with disabilities to perform the essential requirements
• Essential functions may require maintaining the physical condition necessary for sitting, walking or standing for prolonged periods of time; operating a computer and keyboard; near visual acuity to review written documentation; ability to hear and understand speech at normal room levels and on the telephone

Benefits

• Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy
• PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge
• Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively
• Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings
• Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges