Workers Compensation Administrator

Robert Half • San Ramon, CA

2d

About The Position

Robert Half, one of FORTUNE’s World’s Most Admired Companies and a Fortune 100 Best Companies to Work For is hiring a Workers Compensation Administrator to join the Benefit Services department. This role supports the efficient administration of all facets of the North America (NA) Workers' Compensation (WC) Program. The administrator will work collaboratively by effectively communicating and liaising with all stakeholders directly (TPAs, carriers, cross functional teams, vendors and employees) to ensure fair and consistent interpretation of Workers' Compensation programs and policies. They will provide employer oversight of claim processing and claim strategy, influence TPA partners to expedite appropriate resolutions for employee escalations, and proactively recognize and investigate factual discrepancies in claims or claims handling. The role involves evaluating individual claim outcomes, providing workable solutions to the Workers' Compensation Manager, and delivering excellent customer service to NA employees and stakeholders regarding the claim process, including monitoring for return to work. Additionally, the administrator will analyze data to identify opportunities and solutions to improve the employee experience and operational efficiency of the Workers' Compensation Program, act as a subject matter expert regarding WC compliance with US federal and state labor code requirements and Canada provincial requirements, participate in claim reviews, prepare reports, and develop content, communications, and trainings with minimal supervision. They will also assist internal partners and vendors in understanding new programs and changes, and participate in department-wide projects.

Requirements

• Proficient in systems relating to workers' compensation claims administration, claim analytics, loss run reporting.
• Proficient at Excel, Outlook, PowerPoint, Microsoft Word.
• System proficiency with Workday, PeopleSoft, Salesforce a plus.

Responsibilities

• Support efficient administration of all facets of the North America (NA) Workers' Compensation (WC) Program.
• Work collaboratively by effectively communicating and liaising with all stakeholders directly (TPAs, carriers, cross functional teams, vendors and employees) to ensure fair and consistent interpretation of Workers' Compensation programs and policies with TPAs, employees, and business leaders.
• Provide employer oversight of claim processing and claim strategy resulting in efficient management of expense.
• Influence TPA partners to expedite appropriate resolutions for employee escalations.
• Proactively recognize and investigate factual discrepancies in claims or claims handling.
• Evaluate individual claim outcome using various courses of action and provide workable solutions to the Workers' Compensation Manager.
• Provide excellent customer service and respond to all escalated questions/inquiries/requests from NA employees and stakeholders to the claim process and when needed, monitor for return to work.
• Analyze data and identify opportunities and plausible solutions to improve the employee experience and the operational efficiency of the Workers' Compensation Program.
• Act as a first-tier subject matter expert regarding WC compliance with US federal and state labor code requirements, case law regarding workers' compensation statutory benefits and Canada provincial requirements (investigation periods, waiting periods, PPO/MPN networks, employer notice, available employer defenses, subrogation laws, contribution laws, etc.).
• Participate in claim reviews; prepare reports for finance and other key stakeholders.
• Develop content, communications, and lead trainings, webinars and employee meetings with minimal supervision.
• Assist internal partners and vendors in understanding and adapting to new programs and changes.
• Participate in department wide projects, such as Employee Experience Journey Maps or Wellbeing, when required.

Benefits

• group health insurance benefits (medical, vision, dental)
• FSA and HSA healthcare accounts
• life and accident insurance
• adoption and fertility assistance
• paid parental leave of up to 6 weeks
• short/long term disability
• paid time off for vacation, personal needs, and sick time
• up to 17 days of Choice Time Off (CTO) per calendar year
• up to 11 paid holidays per calendar year
• opportunity to contribute to our company 401(k) savings and investment plan or deferred compensation plan (if eligible), with an employer match of 100% on the first 3% of your contributions for eligible employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed