Workers' Compensation Manager

Job Title

Workers' Compensation Claims Administrator

Job Description

Minimum Qualifications

High school diploma or GED, associate or bachelor's degree in health and safety or business administration preferred or an equivalent combination of education and experience sufficient to successfully perform the essential duties of the job such as those listed in this job description.

Minimum of three (3) years of progressively responsible workers' compensation claims administration, claims management, occupational health, risk management, or related experience.

Advanced skills in MS Excel and Microsoft Office Suite.

EMS or healthcare experience is strongly preferred.

UKG experience preferred.

CSCS/CWCA preferred.

Must possess a valid Oklahoma driver's license.

Must be able to successfully pass a background check and drug screen to the satisfaction of the organization.

Essential Functions of the Position

• Claims Intake & Case Management: Manage the end-to-end workers' compensation claims process, including creating, reviewing, and submitting First Reports of Injury and associated documentation for completeness and timeliness.
• Collect and maintain all documentation related to on-the-job injuries, including reports, witness statements, medical records, and accident investigation results.
• Proactive monitoring of all open claims daily for status changes, documenting all communications and updates within the case files.
• Medical coordination: Partner with team members, adjusters, and medical providers to ensure injured employees receive appropriate, timely evaluation and treatment using an approved list of medical providers.
• Serve as the primary point of contact for third-party administrators (TPAs), legal counsel, and insurance brokers to ensure efficient claim resolution.
• Internal communication: contact management, HR, scheduling and the injured team member within 24-48 hours of an incident; provide regular updates to the Director of Risk & Occupational Health regarding claim and return-to-work status.
• Facilitate, schedule, participate in, and keep minutes for periodic claims reviews with operations, adjusters' brokers, and attorneys.
• Facilitate light duty assignments for team members which keep them performing work assignments within their identified restrictions and navigate return-to-work initiatives.
• Present claim trends, loss analyses, financial forecasts, and risk management recommendations to leadership and other stakeholders as needed.
• Conduct comprehensive analysis of workers' compensation, liability, and insurance loss run data to identify claim trends, emerging risks, and opportunities for risk reduction.
• Prepare and manage annual budgets and financial forecasts related to workers' compensation, insurance, claims administration, and risk management programs.
• Perform root cause analyses of workplace incidents, injuries, and claims to identify contributing factors and recommend corrective and preventive measures.
• Will be responsible for administering and tracking temporary total disability (TTD), maximum medical improvement (MMI), and permanent partial disability (PPD)
• Coordinate with scheduling and payroll staff to ensure accurate timecard coding for continuation of pay and light-duty hours.
• Coordinates with Human Resources on injuries arising from occupational injuries or illnesses with respect to matters involving FMLA, EMSA Provisional Leave, ADA accommodations, and/or fitness-for-duty evaluations.
• Collaborates with Risk and Safety Department Team Members on workplace safety, accident prevention, incident investigation, regulatory compliance, injury trend analysis, corrective action initiatives, employee safety awareness, and other programs designed to reduce risk, prevent injuries, and promote a safe and healthy work environment.
• Litigation assistance: prepare materials, evidence, and documentation to assist defense attorneys with hearing, lawsuits, and insurance investigations.
• Regulatory recordkeeping: review incident reports and prepare additional documents to meet organization, safety, and regulatory reporting requirements Oklahoma Department of Labor PEOSH Program forms OK Form 300 Log of Work-Related Injuries and Illnesses, OK Form 300A Summary of Work-Related Injuries and Illnesses, and OK Form 301 Injury and Illness Incident Reports
• Promote safety standards and foster an organizational culture that aligns with EMSA's mission, vision, and values.
• Develop and conduct workers' compensation and safety training for supervisors and team members.
• Adhere to, enforce, and model all organizational policies and safety standards in an ethical and professional manner.
• Administrative flexibility: perform special projects and other duties as assigned by leadership.

Other essential functions include professionalism, the ability to communicate effectively (verbally and in writing), maintaining confidentiality, exercising sound judgment, being adaptable and flexible, following safety and compliance protocols, being accountable, complying with the Code of Conduct, organizational policies, procedures, practices, and expectations, and performing the core duties of the position either with or without a reasonable accommodation.

Other Functions of the Position

Performs other job-related duties, functions, tasks and responsibilities as assigned, which may vary based on evolving organizational needs and priorities. These responsibilities are not considered essential functions of the position and may be modified or reassigned to accommodate individuals with disabilities, in accordance with the Americans with Disabilities Act (ADA) as amended.

Knowledge, Skills, Abilities, and Other Characteristics

• Deep understanding of state and federal workers' compensation laws and OSHA reporting requirements is preferred.
• Strong analytical thinking, negotiation abilities is preferred.
• Ability to work independently with little supervision to meet goals of the department.
• Excellent written and verbal communication skills.
• Excellent organizational and time management skills.
• Attention to detail.
• Ability to handle multiple tasks simultaneously; skill in working in an environment subject to constant interruptions and quickly changing priorities; ability to prioritize responsibilities when necessary; effective time-management skills.
• Self-driven attitude with ability to meet organizational goals.
• Proven ability to build and maintain strong relationships with team members while demonstrating compassion with a sincere dedication to their needs and concerns.
• Must always maintain a high level of confidentiality.

Supervisory Responsibilities

• This position does not have supervisory or management responsibilities of other employees.

Physical Demands

• Must be able to lift up to 25 pounds and occasionally carry, push, pull, or move objects.
• Repetitive motion.
• Substantial movements of the wrists, hands, and/or fingers.

Work Environment

• Work is generally performed in an office sitting at a desk for prolonged periods.
• Limited exposure to external environmental conditions, such as heat, cold, rain, snow and ice.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.