Workers’ Compensation Claims Facilitator - Wailuku, Maui
About The Position
This class reflects responsibility for serving as an intermediary to promote understanding and facilitate the resolution of conflicts which arise during the workers' compensation claims process. The work involves responding to complaints from claimants, employers, physicians, attorneys, and representatives from insurance companies; explaining worker's compensation laws, rules and benefits, and the claims, hearing and appeal processes; explaining the implications that various courses of action may have on a case; securing the cooperation of parties to submit documentation required in order for the case to proceed further; identifying conflicts between award limits prescribed by laws and rules and requested awards; and whenever possible, encouraging the parties to resolve the claim.
Requirements
- Legal authorization to work in the United States.
- Graduation from an accredited four (4) year college or university with a bachelor's degree, or equivalent work experience.
- One and a half (1 ½) years of progressively responsible professional work experience in the area of workers’ compensation including case management.
- Experience dealing effectively with claimants, employers, and/or insurers.
- Knowledge of workers' compensation laws, regulations, procedures, benefits, rights and obligations of parties involved.
- Knowledge of workers' compensation claims management practices.
- Knowledge of insurance industry practices.
- Knowledge of applicable privacy protection laws, rules, and regulations.
- Knowledge of pertinent sources of information on medical terminology, treatment and care of industrial injuries.
- Knowledge of research methods and techniques.
- Knowledge of problem solving methods and evaluative techniques.
- Knowledge of interviewing methods and techniques.
- Knowledge of basic arithmetic (addition, subtraction, multiplication, division).
- Knowledge of report writing.
- Ability to interpret, apply and explain workers' compensation laws, rules, policies, procedures, and benefits.
- Ability to investigate, examine and monitor workers' compensation claims.
- Ability to identify problems and develop alternative solutions.
- Ability to establish and maintain effective working relationships.
- Ability to communicate effectively orally and in writing.
- Ability to prepare clear and concise correspondence and reports.
- Ability to perform basic arithmetic calculations (addition, subtraction, multiplication, division).
Responsibilities
- Serving as an intermediary to promote understanding and facilitate the resolution of conflicts which arise during the workers' compensation claims process.
- Responding to complaints from claimants, employers, physicians, attorneys, and representatives from insurance companies.
- Explaining worker's compensation laws, rules and benefits, and the claims, hearing and appeal processes.
- Explaining the implications that various courses of action may have on a case.
- Securing the cooperation of parties to submit documentation required in order for the case to proceed further.
- Identifying conflicts between award limits prescribed by laws and rules and requested awards.
- Encouraging the parties to resolve the claim whenever possible.
Benefits
- Public Service Loan Forgiveness (PSLF) Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
