Workers Compensation Specialist

PACS

3d

About The Position

The Workers’ Compensation Specialist facilitates and directs Workers’ Compensation processes in accordance with the Legal Risk Department’s established practices and industry recommendations. The role supports Providence Affiliated Facilities in applying employee safety and Workers’ Compensation programs, including claims investigations and reporting, first aid and triage, transportation to medical providers, and return-to-work programs.

The Specialist coordinates communication among injured employees, facility operations, physicians, insurance carriers, claims adjusters, nurse case managers, management, and other staff. The role maintains accurate and confidential claim files, tracks claims through completion, monitors compliance with recommended protocols, prepares reports, and supports risk-avoidance programs. Some overnight travel is required; travel to facility sites may be up to 80% of the time. Work may be in the office or remote, with flextime available to work from home.

Requirements

• Bachelor’s degree from a four-year college or university.
• Ability to organize and prioritize a heavy workload to meet deadlines.
• Trustworthiness and ability to handle highly confidential information with care and discretion.
• Ability to spend prolonged periods standing, speaking, walking, driving, and/or sitting.
• Ability to occasionally lift up to 25 pounds.
• Ability to operate a computer and keyboard, review written documentation with near visual acuity, and hear and understand speech at normal room levels and over the telephone.
• Travel by auto or airline is required; the posting states 25% travel and also indicates travel to facility sites may be up to 80% of the time.

Responsibilities

• Ensure each affiliated facility has access to recommended employee safety and Workers’ Compensation programs and understands how to apply them, including internal claims investigations, timely claims reporting, first aid and triage, transportation to medical providers, and return-to-work programs.
• Contact injured employees and explain the Workers’ Compensation process and the roles of the insurer, employee’s physician, employer, and Wellness Manager during recovery.
• Incorporate claim information into claim files; accurately document conversations and maintain complete electronic records of communications related to claims.
• Ensure claim information and injury reports are accurately and promptly referred to the appropriate insurance carrier.
• Serve as a professional liaison between operations and claims adjusters.
• Ensure facilities maintain contact with treating physicians after visits to obtain work restrictions and information about the employee’s condition and treatment plan.
• Measure and report facility-clinic compliance with recommended protocols.
• Maintain contact with injured employees and gather updates on their health; consult with physicians, nurse case managers, claims adjusters, and project staff regarding adherence to prescribed treatment plans.
• Coordinate among the injured employee, physician, insurance company, nurse case manager, and management to obtain a timely return-to-work release.
• Maintain communication with insurance carriers and prepare critical-claim status reports for management.
• Track assigned claims through successful and timely completion and organize and prioritize workload to meet deadlines.
• Handle highly confidential information with care and discretion.
• Work with brokers and insurers to produce monthly claims reports for Operations.
• Lead monthly internal calls with facility management and quarterly claims reviews with insurers.
• Consult with HR and other PACS staff.
• Develop and assist with implementation of risk-avoidance programs as needed.
• Accept other assignments as needed.
• Travel to facilities and other locations as required, including some overnight travel.

Benefits

• Medical, dental, and vision plans.
• Paid time off and vacation, including holidays.
• Health Savings Accounts and Flexible Spending Accounts.
• 401(k) plan with company contributions.
• Employee Assistance Plan providing confidential support for personal and professional challenges.

What This Job Offers

• Job Type: Full-time