Workers Compensation Specialist

Aspen Dental•New York, NY

3d•$70,000 - $80,000

About The Position

The Workers Compensation Specialist (“Specialist”) will manage the administration of claims for employee incidents for multiple companies located in multiple states. This will include managing the service of insurance carriers (“Carrier”), vendor partners, and any other service providers related to the managing of claims. This position will also support in the areas of Loss Control and Safety Training. Under the general direction of the Claims Manager, Risk Management, the Specialist is responsible for mitigating Worker’s Compensation risk and claims by formulating, developing, and coordinating all claim-related activities. The Specialist will be responsible for ensuring compliance across TAG and supported practices.

Requirements

College degree preferred or greater than two years of claims experience.
Minimum 2 years of experience as a claims analyst, administrator or similar function.
Must demonstrate ability to effectively lead a multi-state program involving employees who are not on-site at at same location.
Customer service experience.
Ability to investigate and direct the claims management process.
Proficiency with Microsoft Office.
Proficiency with Risk Management Information Systems (RMIS).
Must possess strong organizational skills.
Must possess strong communication skills, both written and verbal.
Ability to adapt to changing priorities
Communicates effectively and collaborates
Takes initiative, solves problems, analyzes issues and drives for results
Displays honesty and integrity
Ability to maintain confidentiality
Ability to read and interpret regulatory rules and regulations
Strong presentation skills
Time management skills

Nice To Haves

History of implementing programs to positively impact claim costs a plus.

Responsibilities

Act as a liaison within the company and with customers
Facilitates workers’ compensation claim activities and develops strategies to optimize claim management procedures to drive better claim outcomes.
Works closely with the Manager, Owners, and Company Management to develop and implement programs to address negative trends identified through the review of reports.
Review and manage all incident reports for employee and patient incidents from initial report through conclusion/closure.
Determine need to report claims to carrier for handling.
Payroll and claims reporting for Monopolistic states
Communicate directly with employees in a professional and courteous manner while explaining the claim process.
Coordinates return to work program working closely with HR business leads, medical providers, management, and third parties to enhance participation.
Provide direction and management to third parties to facilitate resolving all claims quickly and cost effectively.
Be available for processing of injured workers treatment and billing as treatment is obtained.
Ensures proper and efficient handling of claims; gathering of claims data and information.
Facilitates claim reviews with third parties and carrier for Workers’ Compensation claims reviews.
BLS annual reporting to states.
Manage Workers' Compensation policy retention and updates based on entity changes.
Attends claim related meetings.
Maintain internal claim files.
Compiles, reviews, and analyzes reports to identify trends.
Understands and communicates claims management philosophy and strategy.
Report all applicable Urgent Care events and claims to the insurance carrier(s).
Create and maintain data in information systems or databases.
Builds, maintains, and manages relationships with third parties, insurance carriers, outside legal counsel and other claims related parties.
Provide support in assessing areas to address related to Safety Training and Loss Control.
Assist in safety training and provide input on safety issues/concerns
Supports risk projects and initiatives.
Promotes loss prevention strategies.