Worker's Compensation Specialist

This is an in-office position - local candidates only

Monday - Friday

8:00 am - 4:30 pm

Position Summary

Under general direction, ensures timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate investigations are completed.

Duties/Responsibilities

• Evaluates accident reports, ensuring the timely processing of medical bills and temporary total disability benefits; reviews medical reports, witness statements, department investigation results, and other documentation.
• Compiles facts and data regarding accident reports and active claims.
• Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued; authorizes payment of medical bills and temporary total disability benefits upon receipt of proper documentation.
• Advises and/or assists departments in conducting an investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation.
• Reviews accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident; advises departments of trends in injuries and proper safety procedures that may result in a reduction of injuries; provides the department with information that will aid in reducing accidents and improve safety.
• Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills.
• Prepares summaries of medical reports.

Required Skills/Abilities

• Working knowledge of the Workers' Compensation Act and other applicable states/federal statutes and regulations.
• Ability to obtain facts that ensure that claims information is complete and accurate.
• Ability to balance casework loads and efficiently process claims.
• Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills.
• Good judgment in interpreting medical facts presented by a physician and applying these facts in determining an individual's capacity to engage in gainful occupation.
• Comfortable interacting with and emailing branches, doctors, medical facilities, witnesses, adjustors, and attorneys.