Workers' Compensation Specialist

Job Description

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

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• 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.
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• Compiles facts and data regarding accident reports and active claims.
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• 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.
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• Advises and/or assists departments in conducting an investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation.
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• 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.
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• Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills.
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• Prepares summaries of medical reports.
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Required Skills/Abilities

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• Working knowledge of the Workers' Compensation Act and other applicable states/federal statutes and regulations.
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• Ability to obtain facts that ensure that claims information is complete and accurate.
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• Ability to balance casework loads and efficiently process claims.
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• Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills.
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• 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.
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• Comfortable interacting with and emailing branches, doctors, medical facilities, witnesses, adjustors, and attorneys.
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