Claims Reviews Specialist (Workers Compensation)
About The Position
Aerotek is hiring a Claims Reviews Specialist (Workers Compensation) at its corporate office in Tempe, Arizona. Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the specialist helps monitor and administer Aerotek’s workers compensation program to contain costs and ensure that the third-party administrator (TPA) manages claims efficiently. The role reviews claims, investigates incidents, coordinates with internal teams and external vendors, and supports claims resolution within established authority. Settlement authority is up to $70,000, and reserve authority is up to $80,000.
Requirements
- High school diploma.
- Three years of work experience in insurance, workers compensation claims management, or risk management.
- Ability to learn the TPA system and generate requested reports.
Responsibilities
- Conduct and document incident and accident investigations in the RIMIS system.
- Ensure the TPA thoroughly investigates initial claims and follows applicable state workers compensation laws and defenses.
- Review and authorize workers compensation settlement offers made by the TPA within the specialist’s authority.
- Monitor medical and disability claim authorizations and payments for appropriateness and accuracy.
- Review claims-handling costs and develop strategies to improve performance.
- Work with the TPA to move claims toward closure.
- Partner with Safety, Human Resources, and Corporate Legal on claims management.
- Make appropriate referrals to external vendors, including defense attorneys, nurse case managers, and investigators.
- Collect OSHA data and update the OSHA field in GRA.
- Coordinate a colleague’s release to transitional duty with the Return to Work Specialist and field office.
- Obtain evidence in contested or litigated claims to support outside attorneys in defending claims and preparing for trial.
- Initiate subrogation when appropriate and authorized by management.
- Prepare for and attend claim review conferences with the TPA; evaluate individual cases, review and adjust financial reserves, negotiate settlements within established authority, and develop detailed, practical action plans with the TPA.
- Review reserves and authorize them for the TPA when appropriate and within authority.
- Review external vendor performance in claims administration and litigation management, and recommend adjustments to the Workers Compensation Compliance Supervisor.
- Monitor workers compensation claims and processing, identify trends and inefficiencies in claims management, and make recommendations as needed.
- Participate in developing strategies to reduce claim frequency and severity.
- Establish and maintain a file and diary for all open claims.
- Help communicate claims trends to the Regional Safety Manager.
- Work with the Compliance Supervisor to develop and conduct workers compensation process and issue training for field offices.
- Attend training sessions, conferences, and workshops to stay current on practices, programs, and legal issues and to convey or gather information needed for the role.
Benefits
- Medical, dental, and vision coverage.
- 401(k) and Roth plans.
- Basic and supplemental life and AD&D insurance.
- Short- and long-term disability coverage.
- Health and dependent care spending accounts (HSA and DCFSA).
- Transportation benefits.
- Employee Assistance Program.
- Tuition assistance.
- Time off and leave, including PTO and primary caregiver/parental leave.
- Annual bonus potential of $4,000.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
