Claims Reviews Specialist (Workers Compensation)

Aerotek•Tempe, AZ

1d•$60,000 - $80,000

About The Position

Aerotek has an immediate opening for a Claims Review Specialist (Workers Compensation) at the corporate office in Tempe, AZ. OVERVIEW Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently.

Requirements

High School Diploma required
3 years work experience in insurance, workers compensation claim management or risk management or
Ability to learn TPA system & generate requested reports

Responsibilities

Conducts and properly document all incident /accident investigations into our RIMIS system.
Ensures the TPA thoroughly and properly investigates all initial claims.
Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses
Within the scope of authority, reviews and authorizes worker’s compensation settlement offers to be made by the TPA
Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate
Reviews costs associated with all claims handling and develops strategies to improve performance
Works with TPA to move claims toward closure
Partners with Safety, Human Resources and Corporate Legal to drive claims management
Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator
Collect OSHA data and update OSHA field in GRA
Coordinates the colleague’s release to transitional duty with the Return to Work Specialist and the Field Office;
Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial
Initiates subrogation where appropriate with management’s authorization
Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions
Review reserves and provide authorization to TPA, where appropriate within authority
Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments
Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed
Participates in developing strategies to reduce claims frequency and severity
Establishes and maintains a file and diary on all open claims
Participates in communicating claims trends to Regional Safety Manager
Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process
Attends training sessions, conferences and workshops to keep abreast of current practices, programs and legal issues for the purpose of conveying and/or gathering information required to perform functions