Workers' Compensation Specialist

Job Description

Job Description

Overview

The Work

The Workers Compensation Specialist provides professional case management and program support for the client’s Workers Compensation program at the Facility in Fort Worth, Texas. This position serves as the lead subject matter resource for Federal workers compensation claim coordination, medical documentation review, return-to-work facilitation, and compliance with OWCP and DFEC requirements.

The position exists to ensure injured employees receive timely, accurate, and well-coordinated support throughout the workers compensation process while helping the client maintain compliance with FECA, OWCP procedures, Privacy Act requirements, and internal safety and health protocols. Because WCF is an industrial manufacturing environment with occupational injury risk, the role is needed to manage claims efficiently, reduce administrative delays, support recovery and return-to-work efforts, and protect the Government’s interests through accurate documentation and sound case management practices.

The job is intended to accomplish complete and compliant administration of workers compensation cases from intake through resolution. Key outcomes include timely submission of CA-1, CA-2, and CA-7 forms; maintenance of complete digitized case files; coordination with injured employees, supervisors, HR, medical providers, and OWCP; development of light-duty or limited-duty job offers; support for medical authorizations and follow-up; and preparation of monthly and annual program reports that demonstrate timeliness, data integrity, and overall program effectiveness.

This position performs all duties and responsibilities in accordance with the Mission, Vision, and Core Values of Cayuse.

Responsibilities

Key Responsibilities

• Lead and coordinate all aspects of Federal workers compensation case management for client facility, ensuring timely and accurate claim intake and documentation, effective communication among injured employees, supervisors, HR, medical providers, and OWCP, and the facilitation of safe return-to-work placements in full compliance with FECA, OWCP standards, and client health and safety policies. The responsibilities for the role include the following:
• Assist the Nurse Case Manager in tracking and monitoring employees injured on the job; Communicate with the injured employee and their supervisor to facilitate return to work, as appropriate
• Communicate with Employee and Supervisor to obtain reports of injuries, facilitate completion of required medical documentation, assist with making medical appointments, and confirming details of work restrictions.
• Perform a Quality Review (throughout the whole process) of the work-related injury documentation and claims to ensure accuracy and completion on: reports of injury, medical documentation, medical appointments, and restrictions, and written job offers.
• Will assist the Safety and Occupational Health Branch and Health Unit as necessary regarding Workers’ Compensation claims.
• Assist and facilitate the post injury follow-up medical and therapy appointments for employees who have filed a workers’ compensation claim.
• Advise supervisors and employees regarding required documentation for workers’ compensation benefits, when requested.
• Will provide correct CA-35 for CA-2 cases (will not hold claims awaiting documentation).
• Ensure all claims paperwork is appropriate, compete and accurate and sent to the client HRS to be forwarded to the Office of Workers’ Compensation Program (OWCP) at DOL within the required time parameters:
  • CA1 & CA2 to be submitted within 10 working days of the injury.
  • CA7’s to be submitted within 5 days working days of the injury.
  • Log claims when forwarded.
• Weekly follow up with OWCP for timely and appropriate authorizations.
• Work with Supervisors to provide light of limited duty assignments when needed.
• Maintain weekly contact with employees for the duration of the light or limited duty assignments to make sure the employee is following medical recommendations and working within the parameters of their duty assignments.
• Work with web-based computer systems, medical software, Occupational Health and Safety software, as well as Microsoft Office Suite software.
• Must maintain data and prepare reports monthly and annually. If in a lead position, the specialist shall be experienced in management, supervising, and guidance to WC employees.
• Attend required meetings.
• Perform other duties as assigned with the OEHS.

Other duties as assigned.

Qualifications

Qualifications – Here’s What You Need

• Bachelor’s Degree in Human Resources, Risk Management, Business Administration, or a Healthcare-related field. An additional five (5) years of direct Federal WC experience may be substituted for a degree.
• Minimum of seven (7) years of experience specifically managing Federal Workers’ Compensation claims under the Federal Employees' Compensation Act (FECA). Experience with state-level WC is not a substitute for FECA expertise.
• Must hold a current certification in Federal Workers’ Compensation Case Management or have successfully completed the DOL-OWCP advanced training suite.
• Demonstrated experience using AQS (Agency Query System). Proficiency in the Microsoft Office Suite and experience with electronic medical record (EMR) systems or the latest case management software (i.e. Cority).
• Must be able to pass a background check. May require additional background checks as required by projects and/or clients at any time during employment.

Minimum Skills:

• Exceptional interpersonal skills with the ability to communicate in a clear, professional, and articulate manner.
• Ability to communicate clearly in person and over the telephone.
• Exceptional verbal and written communication skills.

• Must possess problem-solving skills.
• Highly proficient in Microsoft and Adobe toolsets, including Excel, Word, PowerPoint, Acrobat, etc.
• Highly motivated with the ability to handle and manage multiple tasks at any one time.
• Ability to forge new relationships, individual and teaming in nature.
• Must be a Self-starter, that can work independently and as part of a team.

Our Commitment to you / overview of benefits

• Medical, Dental and Vision Insurance; Wellness Program
• Flexible Spending Accounts (Healthcare, Dependent Care, Commuter)
• Short-Term and Long-Term Disability options
• Basic Life an AD&D Insurance (Company Provided)
• Voluntary Life and AD&D options
• 401(k) Retirement Savings Plan with matching after one year
• Paid Time Off

Reports to: Program Manager

Working Conditions

• Professional medical office environment.
• Keep regular clinic hours as approved by Manager/Director
• Must be physically and mentally able to perform duties extended periods of time.
• Ability to use a computer and other office productivity tools with sufficient speed to meet the demands of this position.
• Visual acuity adequate to perform job duties, including visual examination of patient and reading information from printed sources and computer screens.
• Must be able to establish a productive and professional workspace.
• Must be able to sit for long periods of time looking at computer screen.
• Adequate physical ability including sufficient manual dexterity to perform the requisite health care service.
• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting, with some heavy lifting, pushing and pulling exerted regularly throughout a regular work shift.
• May be asked to work a flexible schedule which may include holidays.
• May be asked to travel for business or professional development purposes.
• May be asked to work hours outside of normal business hours.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Cayuse is an Equal Opportunity Employer. All employment decisions are based on merit, qualifications, skills, and abilities. All qualified applicants will receive consideration for employment in accordance with any applicable federal, state, or local law.