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Workers Compensation Specialist

2 months ago

Ventura, California, United States Community Memorial Health System Full time
Job Summary

We are seeking a highly skilled Workers Compensation Specialist to join our team at Community Memorial Health System. As a key member of our Occupational Health Services department, you will be responsible for providing expert guidance and support in workers' compensation and disability claims management.

Key Responsibilities
  • Provide proactive communication and education to managers and employees on workers' compensation policies and procedures.
  • Coordinate activities between employees, supervisors, medical providers, and third-party administrators to ensure timely and accurate claims processing.
  • Identify and escalate complex claims requiring additional attention and initiate interventions to address claim circumstances.
  • Prepare and submit workers' compensation and disability claims to the third-party administrator within 3 business days.
  • Collaborate with the Occupational Health clinical team to coordinate medical treatment, return-to-work, and leave-of-absence related to workers' compensation.
  • Assist employees with questions regarding workers' compensation benefits and coordination of payroll benefits.
  • Maintain and edit payroll records for employees on workers' compensation and ensure accurate payment of benefits.
Requirements
  • High School diploma or equivalent (GED)
  • Five (5) years' experience in Workers' Compensation Claims Management
  • Knowledge of State and Federal labor laws and regulations
  • Three (3) years' experience in Human Resources or Occupational Health in an acute health care environment within the last five years
  • Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook
  • Bilingual (English/Spanish)
Benefits

Community Memorial Health System offers a competitive benefits package, including:

  • Competitive pay
  • Shift differentials
  • In-house registry rates
  • Fidelity 403(b) Retirement Plan
  • Paid time off
  • Medical (EPO/PPO), dental, and vision insurance coverage
  • Voluntary worksite benefits
  • Employee Assistance Program available 24/7 (EAP)
  • Tuition reimbursement
  • Public Service Loan Forgiveness (PSLF)
About Us

Community Memorial Health System is a community-owned, not-for-profit organization dedicated to providing high-quality healthcare services to our community. We are proud to be the only hospital in Ventura County to earn a prestigious five-star rating from the Centers for Medicare & Medicaid Services (CMS).