Workers Compensation Claims Administrator

Goodwill of Central & Northern Arizona•Peoria, AZ

20h•Onsite

About The Position

Supports the commercial insurance program for Goodwill of Central and Northern Arizona (GCNA) and its affiliated entities, including support for all claims and specializing in claims coordination for Workers’ Compensation. Reviews and coordinates Workers Compensation claims and supports activities for occupational health. Has oversight of the Return to Work program and coordinates communications with the Legal department.

Requirements

High School Diploma or GED required
1-2 years of Claims Administration experience
Proficient in MS Office skills including Word, Power Point, Outlook and Excel, with the ability to perform audits, create spreadsheets and display data
Knowledge of Federal and State laws pertaining to Workers’ Compensation, Liability Statutes and OSHA reporting
Must possess awareness of Human Resources policies and procedures
Excellent written and verbal communication skills
Ability to speak and read English proficiently
Time management and organizational skills as well as the ability to manage multiple priorities with accuracy and efficiency
Skilled in preparing, reading, understanding and interpreting Claims Processing reports
Ability to pass a background check and drug screen, where applicable for position

Nice To Haves

Bachelor’s Degree preferred

Responsibilities

Monitors and maintains cases related to new and existing claims.
Reviews all work-related injuries as reported by management or Team Member and determines reportable vs. recordable injury as well as identifying days restricted and days away from work for workers’ compensation reporting.
Responsible for coordinating claims information submitted by operating units, law enforcement agencies, medical providers, claimants, and attorneys.
Uses independent discretion and decision making to monitor workers’ compensation medical only claims and ensure all proper documentation.
Identifies claims with severe injuries, lost time of potential exposure above $5,000 to Senior Management and/or in-house Attorney.
Proactively identifies risks and provides proper escalation for high-level resolution.
Partners with Safety, Asset Protection, HR, and Legal leadership to escalate problem resolution to ensure a holistic and streamlined approach for each potential exposure.
Maintains proper contact in a professional manner with injured Team Members, and internal and external contacts such as managers, medical providers, etc.
Builds relationships internally and collaborates effectively on cross-functional teams.
Reviews, investigates when necessary and reports claims to insurance carriers for all lines of coverage with all pertinent information, documents, photos, videos, etc.
Assists with claims review, monthly reports and training for reporting requirements.
Processes mail, handles scanning and attaching to appropriate claims.
Identifies mail that requires immediate attention to the appropriate handler.
Administers the Return to Work program, collaborates with the HR Business Partner(s), and supervisors in the placement of Team Members into modified duty work assignments.
Oversees modified duty job offer letters to injured Team Members for management and carrier documentation.
Files documents and develops or modifies filing practices, as needed.
Assists in ensuring compliance with all local, state and federal regulations and requirements at all times.
Supports safety meetings and provides appropriate supporting workers compensation claim related materials to all necessary parties in a timely manner, as requested/needed.
Develops, reviews and implements new policies, programs, processes and procedures, as needed.
Models Goodwill Core Values – Trust, Collaboration, Engagement, Ownership, and Innovation.
May provide support to Asset Protection & Safety, as needed.
Assists in establishing standards and procedures for all matters relating to insurance.
Identifies internal training opportunities.
Supports the development and delivery of specific training related to identified needs.
Performs other related duties, as assigned.