Under general direction, ensures timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure an adequate investigation was conducted. Ensures that company is in compliance with applicable laws and regulations; provides training and guidance to Field Managers in multiple states. Provides high level analysis regarding Risk Management based on claim data.
Evaluate workers’ compensation, property damage and auto liability claims, notify carrier when appropriate, complete all required documentation, notify employee and branch how the claim will be handled, review medical reports and determine appropriate action.
Maintains subrogation records and files for those incidents involving third parties. Sends subrogation letters to third parties in an effort to obtain reimbursement of monies spent by company for medical treatment, time loss, and awards and settlements paid; submits amounts paid for medical treatment and/or temporary total disability benefits to the State Attorney's Office in order to seek reimbursement in cases where criminal charges have been filed.
Compiles facts and data regarding accident reports and filed cases.
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 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 reduction of injuries; provides department with information that will aid in reducing accidents and improve safety.
Trains Field Managers in the proper procedures and forms to be utilized in workers' compensation matters and the preparation of accident reports, notices of absence, and notices of return to work in accordance with city regulations and the Workers' Compensation Act.
Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills; prepares summaries of medical reports; ensures that state Industrial Commission forms are properly prepared and filed.
Attends seminars, conducts research, and maintains liaison with individuals in the medical community and health care fields to keep abreast of current medical procedures and medication
QUALIFICATIONS AND EXPERIENCE:
Working knowledge of the Workers' Compensation Act and other applicable state/federal statutes and regulations.
Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills.
Sound judgement in interpreting medical fact presented by a physician and applying these facts in determining and individual's capacity to engage in gainful occupation.
Proven ability to plan, organize, prioritize and execute high volume of work with a sense of urgency.
Strong communication and interpersonal skills, including written correspondence, creativity, self-motivation, problem solving, and positive, professional attitude.
Strong verbal and written communication skills.
Ability to work under pressure and meet deadlines and goals.
Strong sense of ownership, attention to details, and organizational skills.
Able to work independently and with a team as required.
Strong trouble-shooting and problem-solving skills.
Ability to work evenings and weekends as needed.
Flexibility and ability to adapt quickly to change.
Strong computer skills including Excel, Outlook and PowerPoint.
Working knowledge of federal and state employment laws to include FMLA, ADA, and Title VII.
This position has access to highly confidential, sensitive information relating to the employees, customers, and technologies of Sorenson Communications. It is essential that applicant possess the requisite integrity to maintain the information in strictest confidence.
Additional Duties and Responsibilities:
Prepare annual OSHA 300 logs and state reports
Prepare for Workers’ Compensation annual audit
Attend training classes and carrier meeting as requested
Spend at least five (5) days per year in the field to gain a better understanding of safety issues
Other duties as assigned by department manager
Knowledge, Skills and Abilities:
Ability to maintain satisfactory working relationship with co-works, vendors, the general public and other personnel
Ability to communicate effectively
Requires working knowledge of state worker’s compensation regulations and benefits
Requires ability to obtain facts which assume that incident information complete and accurate
Ability to balance workload and to efficiently and effectively manage and process claims