Workers Comp Claim & Medical Reviewer/Hr Coordinator

State of Maryland•Baltimore County, MD

7d•Onsite

About The Position

The Subsequent Injury Fund (SIF) reviews and investigates workers' compensation claims that involve pre-existing health conditions that substantially increase the disability of injured workers. The liability of employers' insurers is limited to compensation for the damages caused by the current injury, and the SIF incurs all additional liability from the combined effects of all injuries and/or conditions. The Subsequent Injury Fund is seeking an Administrative Officer to provide administrative support to the SIF. This position provides administrative support to the efficient and essential operation of the Subsequent Injury Fund (SIF). This position is designated as the agency FPO, EEO and ADA Coordinator. This position serves as the agency Timekeeping Lead, Leave Bank Coordinator, Agency Benefits Coordinator, Workday Learning Coordinator, Recycling Coordinator and the Maryland InfoPortal Coordinator. This position serves as the Agency HR Coordinator alongside the HR Director. This position is a Senior SIF Claims Department employee and requires expert knowledge of Maryland Workers’ Compensation statute regarding Subsequent Injury Fund liability and is responsible for overseeing claims review, interpretation and written summary of complex medical reports and fiscal liability estimation. This position reviews independent medical examination reports for quality content and fees and has signature authorization for bill payment of SIF independent medical examination bills. This position consults with the Agency Director regarding claims related budget line items (independent medical examination fees, contract surveillance investigations) and recruitment and retention of independent medical examination physicians.

Requirements

Graduation from an accredited high school or possession of a high school equivalency certificate.
Three years of administrative staff or professional work.
Candidates may substitute 30 college credit hours from an accredited college or university for each year up to two years of the required experience.
Candidates may substitute the possession of a Bachelor's degree from a college or university for the required experience.
Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work that included the regular use of independent judgment and analysis in applying and interpreting complex administrative plans, policies, rules or regulations or analysis of operational programs or procedures with recommendations for improvement on a year-for-year basis for the required experience.

Nice To Haves

Experience working with an electronic workers’ comp/medical case control system and preparation of medical report summaries.
Experience working with an online claim service system including document search and copying.
Experience with Workday or comparable Human Resources management system.
Experience as Human Resources Administrator/Assistant to include benefits, equal employment opportunity and disability reasonable accommodation processes.
Experience working with mathematical calculations to include addition, subtraction and percentages.

Responsibilities

Serve as the Agency Benefits Coordinator and Leave Bank Coordinator.
HR Coordinator, assist HR Director in personnel issues, PEP audits and employee morale.
Timekeeper Lead, assist employees with timekeeping issues and ensure all Timekeeping roles are current.
Agency Timekeeper Approver, accurate and timely timekeeping approval during head Approver's absence.
Agency Recycling Coordinator, accurate and timely completion of yearly Department of Environment All STAR recycling report and Recycling Plan review.
Workday Learning Coordinator, run training reports to ensure all employees are current in State and Agency assigned training.
Serve as Agency Employee Motor Vehicle Accident Coordinator.
Electronically prepare and submit OSHA workplace injury reports.
ADA Coordinator, EEO Designated Officer and Fair Practices Officer, address and investigate any EEO complaints, prepare annual EEO report and assign ADA/EEO training.
Address employee requested reasonable accommodations and follow up on resulting effects of established changes.
Recognize potential need for Employee Assistance Program and offer to employee if deemed appropriate.
Assist in new Claim Department applicant interviews and selection.
Lead Secretary II in new case preparation, providing guidance in injury type identification, prior claim research and document creation and revised claim Issues generation.
Review new claims and prepare complex medical report summarizations in TimeMatters electronic case control system.
Calculate and enter potential SIF fiscal liability on TimeMatters immediately after reviewing new case documents and revise when necessary.
Authorize scheduling of independent medical examinations (IME’s) when necessary based on the case profile (claimant’s age, education, work experience skill level, injury severity, preexisting medical history, post accident new conditions and prior WCC claim history) and lead Secretary II in examination scheduling, transportation coordination and appointment reminder calls.
Review independent medical examination reports and surveillance reports for quality content and authorize IME and surveillance investigation bill payments.
Assist Agency Director with the recruitment of independent medical examination physicians and IME fee negotiations and maintain rapport and open communication with all physicians.
Consult with SIF Legal Department personnel regarding complex claim processing legal issues when necessary.
Research prior claim history on the MD WCC Online Archives system to determine potential SIF fiscal liability credit amount.
Immediately investigate all instances of suspected incomplete or inaccurate impleading information.
Accurate and prompt preparation and mailing of appropriate claim related correspondence.
Present case summaries and recommendations for injured workers’ lump sum payment requests at weekly Subsequent Injury Fund Board in Administrative Specialist III’s absence.
Signature authorization to the Fiscal Unit for the accounting allocation of additional funds to the individual accounts of permanent total disability lifetime benefit recipients in Administrative Specialist III’s absence.
Timely processing of Unassigned Hearing Notices report and TimeMatters hearing assignment during Legal Secretary's absence.
Review weekly TimeMatters electronic case control list to identify and prepare all file closures.
Respond to all telephone, mail and email case related inquiries. within 24 hours of notice.
Review all WCC eNotices correspondence and distribute notices to appropriate staff member.
Prepare miscellaneous correspondence assigned by Agency Director within 24 hours of assignment.
In the absence of the Office Secretary, responsible for accurate recording and claim association of incoming paper and electronic medical and legal records and end of workday claims folder secure storage.
Answer incoming calls within three rings and accurately transfer call to the correct extension.
Accurate scanning of closed files to electronic case control system.
Maintain courteous and professional telephone demeanor.