Workers Compensation Specialist Job Description
Workers compensation specialist
provides and ensure accurate and timely management of lost time, high risk and catastrophic workers compensation claims.
Workers Compensation Specialist Duties & Responsibilities
To write an effective workers compensation specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included workers compensation specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Investigates claim to determine coverage and whether benefits are due and provides results of investigation to third party administrator adjuster
Evaluates and responds to third party administrator requests for settlement and reserve authority
Evaluate claims to determine potential exposure
Has extensive experience of handling workers compensation claims for large, National clients
Knowledge of general liability or other types of claims a plus
Help develop and execute the strategies of the practice - leading full team (including Risk Control Consultant and Data Analyst) on creating strategy for larger account
Consults with client to help mitigate their risk
Experience working with clients in various industries including retails and construction
Some travel may be required, particularly throughout California
Investigates claims to determine whether coverage is provided, establish compensability and verify exposure
Workers Compensation Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Workers Compensation Specialist
List any licenses or certifications required by the position: SIP, CA, PHR, SCLA, AIC, CPCU, SCP, CP, SHRM, SPHR
Education for Workers Compensation Specialist
Typically a job would require a certain level of education.
Employers hiring for the workers compensation specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Education, Business, Management, Business/Administration, Human Resources, Legal, Law, Associates, Finance, Technical
Skills for Workers Compensation Specialist
Desired skills for workers compensation specialist include:
Basic medical terminology related to the cause and treatment of occupational injuries and diseases
Applicable legislation
Chapter 440
Data management systems and processes
Equivalent workers’ compensation statute in another State
Federal Safety requirements
Florida Statutes
Jurisdiction law
Legal process
Multi-state Workers Compensation lost time statues
Desired experience for workers compensation specialist includes:
10 years of experience in the claim industry
Bachelor's degree in Business, Healthcare Administration or related field strongly preferred, High School Diploma required
2-3 years of experience working in workers’ compensation, managed care, claims management programs, or experience managing a provider office required
Familiarity with workers’ compensation and/or managed care business processes and strategic concepts
Understanding clinical terminology, Network design and the comfortable operating within medical provider communities
Strong Microsoft Excel and Microsoft Office skills required
Workers Compensation Specialist Examples
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Workers Compensation Specialist Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of workers compensation specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for workers compensation specialist
- Provide timely responses to DOT Verifications for internal and external inquiries
- Manage TPA contracts affecting position responsibilities to ensure services are being performed and executed as required by master services agreement
- Reports the workers compensation claims to the TPA
- Communicates with injured workers by providing compassionate and caring guidance as their advocate during the claim process
- Coordinates with claim adjusters to determines appropriateness and amount of worker's compensation claims, and to investigates individual claims for eligibility for workers' compensation benefits
- Assists supervisors in providing injured employees with alternative work assignments or creating light duty or restricted duty assignments whenever possible for injured employees
- Liaisons between management, claim adjuster, outside counsel and injured employee to manage return-to-work and minimize litigation risk for the company
- Monitors the status of the claims, and provides periodical reports to management
- Manages the workers compensation claim from start to end, and drives timely closure of the claims
- Responds to and resolves escalated leaves of absence matters
Qualifications for workers compensation specialist
- 7 or more years of claims handling experience with 2 or more years in Workers’ Compensation Claims
- Experience handling Indiana, Michigan, Illinois and/or Iowa claims
- Experience handling Illinois and/or Wisconsin Workers’ Compensation Claims
- Experience handling Illinois and/or Minnesota Workers’ Compensation Claims
- Bachelors Degree and 6 or more years of workers' compensation claims handling experience
- In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims
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Workers Compensation Specialist Job Description
Job Description Example
Our growing company is looking for a workers compensation specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for workers compensation specialist
- Develops and maintains LOA metrics, analyzes data for trends and provides recommendations for improvement
- Collaborates with workers’ compensation vendor, attorneys and adjustors to evaluate, investigate and resolve claims
- Represents the Company in workers’ compensation related hearings with system board/arbitration to include researching leave history, absence trends
- Assists in the on-going development and improvement of LOA policies and procedures
- Provides Associate leave history, absence trends, to supervisors, managers, and employee relations, as required
- Provides oversight of part-time on-site ergonomist/physical therapist contractor
- Conveys more complex information (coverage, decisions, outcomes, ) to all appropriate parties, maintaining a professional demeanor in all situations
- Coordinates independent safety evaluations to assess safety and health programs and to control risks and losses including, but not limited to the Injury and Illness Prevention Program (IIPP), Return to Work Program
- Leads new-employee health and safety orientations, and assists in the development of materials for these presentations
- Assists with governmental inspections, independent audits or facility visits
Qualifications for workers compensation specialist
- CA jurisdiction experience preferred, but will consider strong applicants with other jurisdictional experience
- Bachelors Degree and 2 or more years of experience in the Insurance Industry area
- High School Diploma or Equivalent and 4 or more years of experience in the insurance industry area
- Experience working on Defense Base Act and/or Workers Compensation claims
- Experience in handling claims and detailed knowledge of applicable state jurisdictional Workers' Compensation rules and regulations for GA, TN, MS, AL – required
- Ability to use independent judgment and make appropriate insurance claims adjustment decisions and determinations
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Workers Compensation Specialist Job Description
Job Description Example
Our growing company is looking for a workers compensation specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation specialist
- Identifies and appraises conditions which produce accidents and financial losses and evaluates the potential extent of injuries resulting from accidents and prepares reports on the conditions identified and action taken to mitigate the potential exposure
- Oversees safety committee meetings and activities
- Updates and maintains OSHA log and appropriate records on hazards and personnel injury occurrences
- Coordinates workers’ compensation claims in accordance with state regulations, Company policy and procedures
- Coordinate post injury care with Company’s onsite medical clinic program and other medical providers
- Represent Earthbound Farm at workers’ compensation claim review meetings and hearings as required
- Administer First Reports of Injury
- Ensure timely processing of claims, coordinate medical care as necessary
- Review witness statements, compile facts and data regarding accident reports and filed cases
- Works closely with TPA for claims resolution
Qualifications for workers compensation specialist
- High school diploma or GED, Bachelor's degree (B.A
- At least 5 years related leave of absence (FMLA administration) and workers’ compensation experience
- Experience working with third-party LOA Adminstrators ideal
- Experience in a 1,000+ employee based company ideal
- Background with a Union employer preferred, but not required
- Bachelor’s degree in in health and safety or business administration
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Workers Compensation Specialist Job Description
Job Description Example
Our growing company is searching for experienced candidates for the position of workers compensation specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation specialist
- Advises and assists department in conducing investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation
- Advises departments of trends in injuries and proper safety procedures that may result in a reduction of injuries
- Provides information and training that will aid in reducing accidents and improve safety
- Trains managers in proper procedures and forms to be utilized in workers compensation and safety matters, and in the preparation of accident reports, notices of absence, and notices of return to work in accordance with regulations under the Workers Compensation Act
- Ensures that State Industrial Commission forms are properly prepared and filed
- Conducts research and works well with leaders and employees in other departments and management positions
- Compile and review claim data
- Negotiate and settle lower dollar medical-only worker’s compensation subrogation claims
- Aggressively manage all workers’ compensation claims to resolution, including conducting causal analysis, identifying indicators of potential fraud, developing initial action plans, managing reserves
- Correspond with the local site advocates and management, witnesses, treating doctors and clinics, adjusters, attorneys, designated vendors and injured employees as needed within the first 24 hours of incident and throughout the life of the claim
Qualifications for workers compensation specialist
- Can independently prioritize and manage meaningful responses to internal and external players
- Strong communication skills to include written, oral and group presentation
- Applicant will at some point be required to obtain CA Independent Adjuster License
- 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
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Workers Compensation Specialist Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of workers compensation specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation specialist
- Visit and assess performance of local occupational healthcare clinics
- Work closely with the Corporate Risk Management Department on the management of any complex claims as defined in the company’s existing WC Claims Handling protocols
- Liaison with Human Resources for short-term/long-term disability and FMLA when applicable
- Monitor all open cases daily for any change in status
- Prepare/present bi-weekly report on status of all open claims and participate on calls with Corporate Risk Management for safety analysis and ongoing claim strategy discussions
- Responsible for maintenance of accident, sickness, and near miss records
- Responsible for maintaining accurate OSHA Injury and Illness Logs for all locations, with Corporate oversight
- Assist the company’s defense attorney(s) in preparation of cases
- Assist in selection of new panel doctors when necessary for treatment of workers’ compensation claims and Independent Medical Evaluations
- Facilitate return to work initiatives with local management for workers’ compensation cases
Qualifications for workers compensation specialist
- Ability to conduct fact-finding investigations
- Ability to prepare and maintain records relating to a workers' compensation program
- Ability to negotiate and facilitate resolution agreements
- Strong knowledge of current OSHA regulations, IIPP and compliance requirements
- Knowledge of cleanup/containment of hazardous materials/situations as a result of spills or systems failures
- Must be able to communicate issues in a constructive manner and handle difficult and/or confidential situations in a professional manner