UNIV - Workers’ Compensation Coordinator - Department of Insurance Services

Medical University of South Carolina•Charleston, SC

13d•$52,100 - $88,600•Onsite

About The Position

The purpose of this position is to provide technical and professional services to the Workers’ Compensation Division of the Office of Insurance Services. Assist in processing and monitoring injury cases for employees of MUSC, MUHA Charleston and/or MUHA regional hospitals which includes but is not limited to, assisting employees who have sustained a work- related injury through submission of a claim to our insurance carrier or through management of self-insured claims. Provide technical and professional assistance (for insured and self-insured claims) from notification of potential claim to closure. Coordinate billing of MUSC and MUHA self-insured claims. Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in injury databases/claims management system as required by regulatory bodies and for analysis and dashboard reporting for MUSC and/or MUSC Health System and in support of the Insurance Services shared service agreements. Serve on various committees as needed.

Requirements

Knowledge of laws, regulations, policies and procedures relevant to workers' compensation.
Ability to interpret and apply applicable laws, regulations, policies and procedures.
Employee should be familiar with the S.C. Workers' Compensation Law and OSHA injury reporting requirements.
Strong Data Analysis skills.
Ability to establish and maintain effective working relationships.
Ability to communicate effectively, both orally and in writing.
Strong planning and organizational skills.
Demonstrated ability to effectively prioritize competing tasks and manage multiple responsibilities in a fast-paced environment.
Proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and data reporting tools
Excellent customer service, verbal, and written communication skills.
Employee works under the direct guidance of the Workers’ Compensation Manager but must be able to work independently with latitude to use discretion and sound judgment in making decisions.
A bachelor's degree and two years relevant program experience.

Responsibilities

Assist in processing and monitoring of assigned MUSC and /or MUHA injury claims, including insured and self-insured claims, from notification of potential claim until closure of claim.
Provide technical and professional assistance in case management, transition back to work assistance, claim investigations, and settlements.
Case management can include scheduling of appointments, obtaining current medical information, and assisting the injured employee by providing a liaison with a State Accident Fund (SAF) adjuster and/or nurse case management vendor. Submits timely acknowledgements of new injury reports to injured Care Team Member and Manager as appropriate.
Facilitate transition back to work initiatives for injured workers to include assisting managers and coordinating alternative assignments or modified duty assignments when appropriate. Ensure continued communication with injured worker, manager of injured worker, HR, EHS, SAF, and nurse case management vendor.
Respond promptly to inquiries from injured worker, manager of injured worker, EHS, HR, SAF, and nurse case management vendor.
As directed, act as MUSC/MUHA representative for depositions, conferences, mediations, or hearings, working with assigned attorneys, employees, and carrier representatives, as necessary.
Maintain all assigned MUSC and MUHA Injury data as required by regulatory bodies such as OSHA and Joint Commission. Ensure accurate data for determining OSHA recordability is documented. Prepare and manage OSHA Logs.
Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in injury databases/claims management system for analysis and dashboard reporting for MUSC and/or MUSC Health System and in support of the Insurance Services shared service agreements.
Maintain database of modified duty assignments.
Manage database of charges for analysis and prepare reports as requested.
Prepare injury-related reports at required intervals as requested by leadership for various organizations and departments. Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in claims management system/injury databases for analysis and dashboard reporting.
Coordinate billing of all MUSC and MUHA self-insured workplace injury claims.
Respond to facility, physician, and pharmacy internal billing representatives regarding billing.
Ensure accurate invoicing and payment based on current workers ‘compensation payment schedules for facility, physician, and pharmacy charges. Prepare and submit bills for processing in a timely manner.
Respond promptly to inquires regarding billing issues and escalate to appropriate hospital and physician billing representatives and/or SAF as appropriate.
Provide continuous support of aforementioned duties to MUHA Regional Health Network hospitals as needed.
Assist in ensuring out-of-state, remote workers are adequately insured and claims managed.
Carries out special projects, serves on various committees as needed, and performs assignments as directed by the Workers’ Compensation Manager and Insurance Services leadership. This position is considered an essential position.