Workers' Compensation Specialist

GENERAL DESCRIPTION:

The Workers Compensation plays a vital role in ensuring the health, safety, and well-being of all team members across the organization. This position is the primary contact for all team member related workplace injuries. Collaborates effectively with injured team members, managers, and external stakeholders to ensure the appropriate administration of the workers’ compensation program. This includes, but is not limited to, accurate and timely claims recording keeping, monitoring, preparing accurate claims trends analysis reporting, ensuring full compliance with applicable laws and regulations, and effectively communicating with team members, their supervisors, company stakeholders, healthcare providers, and insurance partners.

ESSENTIAL FUNCTIONS:

Execute established internal workers’ compensation policies, procedures, and best practices. Collaborate with internal stakeholders to ensure program alignment with organizational goals and regulatory requirements. Investigate and process workers’ compensation claims, including reviewing medical reports and accident documentation with assigned case workers. Ensure all reporting and recordkeeping comply with regulatory requirements. Serve as the primary point of contact for injured employees, providing guidance and support throughout the claims process. Communicate with managers, medical providers, insurance carriers, legal representatives, and third-party administrators to coordinate case management. Review and analyze accident reports to identify injury trends and assess contributing factors; advise stakeholders on preventive measures to reduce accidents and improve safety. Monitor and record leave usage related to workers’ compensation claims. Monitor and manage workers’ compensation claims to ensure timely submission, appropriate care, and efficient case resolution. Maintain accurate and confidential records of claims, treatment authorizations, and related documentation. Function as a liaison between the return-to-work program, employees, and third-party administrators. Stay current on federal and state regulations, industry best practices, and emerging trends through research, seminars, and professional development. Provide training, education, and clear communication to stakeholders on workplace safety, injury prevention, and the workers’ compensation process. Coordinate with stakeholders to support efficient claims resolution and safe return-to-work transitions. Collaborate with stakeholders to ensure alignment on claims resolution.

KNOWLEDGE, SKILLS, AND ABILITIES:

Demonstrated knowledge of workers’ compensation and regulations. Familiarity with return-to-work programs and workplace accommodations. Excellent interpersonal, written, and verbal communication skills, focusing on empathy and inclusivity. Strong organizational skills and attention to detail, with the ability to manage multiple responsibilities effectively. Ability to manage sensitive and confidential information with professionalism and integrity. High level of personal accountability, ownership of outcomes and a proactive approach to problem solving. Proficiency with claims management software and Microsoft Office Suite. Ability to remain calm, compassionate, and composed while interacting with individuals in stressful or emotionally charged situations.

EDUCATION AND WORK EXPERIENCE:

An associate or bachelor's degree in human resources, business administration, risk management, occupational safety, or a related field is preferred. Equivalent combination of education and relevant experience may be considered. Minimum 2 years of experience in workers’ compensation administration, occupational health and safety, risk management, or a related field. Experience with claims management systems, and coordinating with third-party administrators or insurance carriers is strongly preferred.

PHYSICAL DEMANDS:

This role is primarily office-based with occasional visits to work sites which may involve exposure to various indoor and outdoor environmental conditions. While performing the duties of this job, the employee is regularly required to talk and/or listen. The employee frequently is required to stand, walk, use hands and fingers, handle and/or feel; lift/carry up to twenty-five pounds, and reach with hands and arms. Must be able to lift and/or carry up to 25 pounds occasionally. Visual acuity required for reading documents, computer screens, and conducting workplace observations. #J-18808-Ljbffr Tire Discounters, Inc.