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Workers Compensation Claims Specialist
2 months ago
Aerotek is seeking a highly skilled Workers Compensation Specialist to join our team. As a key member of our risk management team, you will be responsible for monitoring and administering our workers compensation program to ensure maximum cost containment.
Key Responsibilities:- Conduct thorough investigations into workplace incidents and accidents, documenting all findings in our RIMIS system.
- Ensure that our Third Party Administrator (TPA) thoroughly investigates all initial claims, adhering to state workers compensation laws and defenses.
- Review and authorize worker's compensation settlement offers made by the TPA, within the scope of your authority.
- Effectively monitor medical and disability claim authorizations and payments to ensure their accuracy and appropriateness.
- Develop strategies to improve performance and reduce costs associated with claims handling.
- Work closely with the TPA to move claims toward closure and partner with Safety, Human Resources, and Corporate Legal to drive claims management.
- Make referrals to outside vendors, such as defense attorneys, nurse case managers, and investigators, as needed.
- Coordinate employee releases to transitional duty with the Return-to-Work Specialist and the Field Office.
- Obtain evidence in contested and/or litigated claims to assist outside attorneys in defending claims and preparing for trial.
- Initiate subrogation, where appropriate, with management's authorization.
- Prepare for and attend Claim Review Conferences with the TPA to evaluate individual cases, review and adjust financial reserves, and negotiate settlements within established authority.
- Conduct bi-annual audits to ensure the TPA is meeting best practices requirements.
- Review reserves and provide authorization to the TPA, where appropriate, within your authority.
- Monitor and review workers compensation claims and claims processing, identifying trends and inefficiencies, and making recommendations as needed.
- Participate in developing strategies to reduce claims frequency and severity.
- Establish and maintain a file and diary on all open claims.
- Communicate claims trends to the Regional Safety Manager.
- Develop and conduct training to field offices regarding workers compensation issues and processes.
- Attend training sessions, conferences, and workshops to stay up-to-date on current practices, programs, and legal issues.
- High school diploma and 3 years of work experience in insurance, workers compensation claim management, or risk management.
- Associate in Arts/Sciences and 2 years of experience in workers compensation, or risk management, or related field.
- Bachelor's Degree with 2 years of work experience in insurance, workers compensation claims management, or risk management.
- Ability to learn the TPA system and generate requested reports.
