WORKERS' COMPENSATION SPECIALIST - 43000573

State of Florida • Tallahassee, FL

7d

About The Position

This is a highly responsible and professional position in the investigation, evaluation and payment of workers' compensation claims handled by the Division of Risk Management. Work is performed under the general supervision of the Workers’ Compensation Administrator, but work is performed independently, exercising a great deal of independent judgment. Performance is reviewed by audit of work product, reports and personal conferences. Principle duties consist of the following: The Workers' Compensation Specialist conducts detailed investigations of workers' compensation claims submitted to Risk Management on state employees, applies the appropriate laws, and makes a determination of compensability. The Specialist evaluates medical reports, authorizes medical treatment, determines if rehabilitation is needed, authorizes compensation payments and settlements. The Specialist must calculate and maintain proper monetary reserves on claims and must recognize and pursue recoveries either through subrogation or the Special Disability Trust Fund. The Workers’ Compensation Specialist handles workers' compensation claims that have been assigned to defense counsel by directing defense activity to conform to sound claims handling principles. The Workers’ Compensation Specialist attends formal workers' compensation mediations and hearings when necessary. The Workers’ Compensation Specialist assists and advises the Claims Coordinators of various state agencies, departments, divisions, bureaus, and sections with questions concerning workers' compensation claims, including but not limited to, questions of coverage, compensability, medical treatment and reporting work related accidents. As needed, the Workers’ Compensation Specialist monitors the activities of Risk Management's prior service companies and also timely and accurately completes all DWC forms necessary for Electronic Data Interchange Reporting. The Workers’ Compensation Specialist performs other related work as required.

Requirements

• Knowledge of the principles and techniques of effective communication.
• Ability to examine and evaluate data relating to a workers' compensation program.
• Ability to understand and apply applicable rules, regulations, policies, and procedures relating to a workers' compensation program.
• Ability to handle telephone calls in a fast, courteous, and effective manner.
• Ability to deal with the public in a tactful and courteous manner.
• Ability to work independently.
• Ability to utilize problem-solving techniques.
• Ability to conduct fact-finding investigations.
• Ability to plan, organize and coordinate work assignments.
• Ability to communicate effectively.
• Ability to establish and maintain effective working relationships with others.
• Ability to prepare and maintain records relating to a workers' compensation program.
• Ability to negotiate and facilitate resolution agreements.
• At least six (6) months’ experience working in a position requiring working knowledge of Chapter 440, Florida Statutes or equivalent statute is required.

Nice To Haves

• Currently, or previously had Florida Adjuster License.
• At least one (1) year experience adjusting workers’ compensation claims within the last three (3) years.
• At least one (1) year working in workers’ compensation insurance claims business.
• At least one (1) year working in workers’ compensation insurance claims business in the State of Florida.
• Working experience with any risk management information systems and/or any software programs designed to assist adjusting workers’ compensation claims.
• Experience adjusting permanent total disability claims.
• Bachelor’s degree from an accredited college or university.

Responsibilities

• Conducts detailed investigations of workers' compensation claims submitted to Risk Management on state employees, applies the appropriate laws, and makes a determination of compensability
• Evaluates medical reports, authorizes medical treatment, determines if rehabilitation is needed, authorizes compensation payments and settlements
• Calculates and maintain proper monetary reserves on claims and must recognize and pursue recoveries either through subrogation or the Special Disability Trust Fund
• Handles workers' compensation claims that have been assigned to defense counsel by directing defense activity to conform to sound claims handling principles
• Attends formal workers' compensation mediations and hearings when necessary
• Assists and advises the Claims Coordinators of various state agencies, departments, divisions, bureaus, and sections with questions concerning workers' compensation claims, including but not limited to, questions of coverage, compensability, medical treatment and reporting work related accidents
• Monitors the activities of Risk Management's prior service companies and also timely and accurately completes all DWC forms necessary for Electronic Data Interchange Reporting
• Performs other related work as required

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 1,001-5,000 employees