Workers' Compensation Specialist

1 month ago

Houston, United States Vestas Full time

Leave & Workers Comp Analyst

Location: Houston, TX

General Purpose:

We need you We are looking for a customer service professional to join our team This role is a conduit between all business units, P&C Stakeholders, and our TPA(s). First-line contact for third-party provider and employees/managers with leave of absence and workers compensation claims; coordinate with payroll to ensure proper pay and recordkeeping; assist work facilities with health and safety policies, standards, and procedures as needed.


Responsibilities:

Leave of Absence

Assist employees with submitting claims and provide support throughout the life of the claim.

Communicate with managers of LOA employees regarding claims, approvals/denials, and other inquiries.

Coordinate daily interactions with employees, managers, third party administrator including phone calls and emails regarding leave of absence questions and processes.

Manage all inquiries to the VAME inbox for leaves.

Escalate sensitive and near termination claims to HRBP.

Administer return to work process to return employees timely to position.

Support at-work accommodation process as needed with stakeholders and TPA.

Workers Compensation

When notified of a worker’s compensation situation, complete the pre-claim process within one business day of receipt.

Provide support to the employee, manager, and worker’s compensation providers throughout the life of the claim including status updates, answering employee’s questions, working with the doctors’ to ensure all information is documented, and submit reimbursements for the employee.

Complete the claim closure process including coordinating the fit for work, work through a settlement, work with the worker’s compensation attorneys, and attend hearings.

Run audits and reports.

Other:

Support with Open Enrollment and other annualized benefit projects.

Perform other tasks as assigned.

Participate in projects, webinars, and meetings as assigned.

Facilitate leave of absence workers compensation training for site supervisors and employees using a variety of media as appropriate to audience and subject.

Partner with stakeholders to ensure consistency in application of policies, procedures and recordkeeping.

Provide day-to-day support for other stakeholders as needed.


Essential Functions:

High level of customer service required.

This is a shared role. Teamwork and collaboration is essential.

Is proactive and take initiative to understand and solve issues with claims, stakeholders, or TPA within the scope of responsibilities.

Proficiency in Microsoft Office Suite (Windows, Word, Excel, Power Point, Outlook, and Teams).

Manage and organize shared Outlook inbox’s according to outlined structure.

Accurate documentation is a major function of the job; reports and findings are typically in MS Word and Excel spreadsheets.

Ability to utilize internal database systems, external software programs, and TPA systems.

Up to 10% travel may be required but varies based on needs and budget.

Regular and reliable attendance is required.



Education, Training, and Skills Required:

High school diploma is required. Associates Degree or above is desirable. Combination of 3-5 years of customer service, leave administration, or worker’s compensation experience and education is required with at least 2 years of relevant work experience.

Experience in a multiple location organization; prefer manufacturing.

Ability to prioritize your work.

Ability to interact frequently with others in a professional and courteous manner.

Experience in providing a high level of customer service and support. This position assists people at a tough time in their life, and must maintain a positive, respectful attitude.

Bi-lingual (Spanish) would be a bonus.

Experienced in interpreting and communicating regulating agency rules; understands when to seek guidance regarding more complex issues.

Experience working with insurance companies.

Must write and communicate in clear English, technical information to audiences with varying levels of education and knowledge of safety.

Demonstrated leadership; interpersonal and in communication.

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