Workers Compensation Specialist

PACS

1d•Hybrid

About The Position

The Workers’ Compensation Specialist will facilitate and direct all Workers’ Compensation processes in accordance with established Legal Risk Department and Industry Recommended Practices. This role involves initiating contact with injured employees, explaining the Workers’ Compensation process, and acting as a liaison between various parties to ensure a timely return to work. The specialist will also be responsible for maintaining accurate claim files, documenting communications, and preparing status reports. This position requires strong organizational skills, trustworthiness, and the ability to handle confidential information with discretion. The role also involves developing and assisting in the implementation of risk avoidance programs and accepting other assignments as needed. Some overnight travel is required.

Requirements

Bachelor's degree (B.A.) from a four-year college or university.
Ability to spend prolonged periods of time standing, speaking, walking, driving, and/or sitting.
Requires ability to occasionally lift up-to 25lbs.
Ability to hear and understand speech at normal room levels and on the telephone.

Nice To Haves

Must be trustworthy and can handle highly confidential information with the utmost care and discretion required.

Responsibilities

Facilitate and direct all Workers’ Compensation processes in accordance with established Legal Risk Department and Industry Recommended Practices.
Assure each Providence Affiliated Facility has access to all Recommended Employee Safety and Workers Compensation Programs and they understand how to properly apply: Internal Claims investigation, accurate and timely Claims Reporting, First Aid and Triage, Transportation to MPN and RTW programs.
Initiate contact with injured employees and explain the Workers’ Compensation process as it relates to the injured employee.
Provide an overview of the Insurance Company, Employee’s Physician, Employer and the Wellness Manager’s roles during the recovery.
Incorporate all claim information into the Claim File.
Accurately and completely, document conversations and maintain an accurate electronic file of communication related to the injured employee’s Workers’ Compensation claim.
Assure report claim information and injury reports are accurately and promptly referred to the appropriate insurance carrier.
Work as professional liaison between operations and claims adjuster.
Assure each facility maintains contacts with treating physician after injured employee’s visit obtain work restrictions and information on injured employee’s condition and treatment plan.
Measure and report compliance of clinics with our recommended protocols.
Remain in contact with the injured employee and gather information on the status of the injured employee’s health condition.
Consult with the employee’s physician, nurse case manager, claims adjuster, and project staff to determine if the injured employee is following the treatment plan prescribed by the employee’s physician.
Act as a liaison between the injured employee’s physician, insurance company, nurse case manager, management, and employee to gain a timely return-to-work release.
Maintain communication with the insurance carrier; prepare status reports on critical claims for management.
Track the status of assigned claims to their successful and timely completion.
Organize and prioritize a heavy workload to meet deadlines.
Handle highly confidential information with the utmost care and discretion.
Work with Broker and Insurer to produce monthly claims reports to Operations.
Direct monthly internal calls with Facility management, Quarterly claims reviews with Insurer.
Work as Consultant to HR and other PACS staff.
Develop and assist in implementation of Risk Avoidance Programs as necessary.
Accept other assignments as needed.