Experience: Two (2) years of full-time work experience that is equivalent with the oversight of a Worker’s Compensation program including investigation and litigation of claims, Claims Disability Management or a Return to Work Program.
Job Summary: This position administers the Company’s and its entities Workers Compensation Program. The position is responsible for the timely processing of employee claims, evaluates accident reports, to determine accuracy and completeness to provide adequate investigation. This position will review existing policy and procedural administration of around100 open claims on average for over 1000 employees.
Responsibilities: The information listed below is meant to serve as samples of job duties and responsibilities for this position. This list is neither inclusive nor exclusive of the types of duties performed.
Confers with and advises management and employees regarding Workers Compensation policies and procedures.
Administers the Company’s fully-insured and self-insured workers’ compensation programs.
Works closely with the Safety Department to assess causation and formulate responses to workplace/work-related incidents and identify loss drivers.
Represents the Company at various claims review meetings.
Compiles facts and data regarding accident reports and filed cases.
Establish and maintain a communication link with the injured worker and treating physician to ensure proper medical treatment is provided.
Evaluate current physician and facility care roster to determine the quality of care.
Administer and maintain the Return to Work program that extends to all departments within the Company.
Ability to review and evaluate open claims and reserve amounts and work with insurance carriers to close open claims as quickly as possible.
Provide monthly and quarterly reports to management.
Establish good communication between the injured worker, supervisors, management, and insurance carriers.
Knowledge & Skills
California Workers Compensation rules, regulations, and statutes.
Federal & State OSHA, American Disabilities Act (ADA), Family Medical Leave (FMLA), California Family Rights Act (CFRA) and rules relating to industrial accidents and injury leaves of absence
Ability to maintain caseload, efficiently and timely process claims, and multi-task with other projects.
Claims administration and investigation techniques
Interpreting and/or developing rules, regulations, policies, and procedures relating to Worker Compensation.
Gather and analyze data; research, analyze and make recommendations on complex issues.
Effectively manage multiple work assignments, set priorities, and meet established deadlines
Bilingual in English and Spanish effectively both orally and in writing.
Handling confidential matters discreetly and effectively
Prepare clear and concise reports and correspondence.
Demonstrate and maintain a high degree of initiative, maturity, integrity, loyalty, and good judgment