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Claims Management Specialist

2 months ago

Madison, Wisconsin, United States University of Wisconsin Full time
POSITION OVERVIEW

The University of Wisconsin is a distinguished public higher education system, educating approximately 162,000 students annually and employing around 35,000 faculty and staff statewide.

The Office of Risk Management is dedicated to fostering a safe and healthy educational environment for all individuals involved in UW System programs and facilities.

KEY FUNCTIONS
The Office of Risk Management aims to achieve its mission through:

  • Proactive loss prevention and health safety initiatives
  • Comprehensive management of property, liability, and workers' compensation claims
  • Protection of UW System assets
  • Conducting risk assessments and developing mitigation strategies

This role involves managing a designated segment of university employee workers' compensation claims under the guidance of the Senior Examiner and the Risk Manager.

PRIMARY RESPONSIBILITIES
Key responsibilities include:

  • Receiving and investigating claims to determine approval, suspension, or denial in accordance with statutory guidelines.
  • Issuing timely workers' compensation benefits and maintaining accurate case reserves following compensability determinations.
  • Interpreting and assessing medical documentation to ascertain benefits.
  • Handling sensitive employee data and medical records with confidentiality.
  • Recommending the use of third-party services such as private investigations and independent medical evaluations.
  • Evaluating potential third-party lawsuits and informing relevant parties of the state's subrogation interests.
  • Assisting campuses in developing early return-to-work programs to facilitate the recovery and employment of injured workers.
  • Authorizing and processing medical bill payments as necessary.

MINIMUM REQUIREMENTS
While prior experience in workers' compensation is advantageous, entry-level candidates are welcome as on-the-job training will be provided. Candidates must possess:

  • Exceptional written and verbal communication skills
  • Proficiency in Microsoft Office Suite
  • Strong customer service capabilities
  • The ability to analyze complex issues and make independent decisions

PREFERRED QUALIFICATIONS
Ideal candidates will have substantial experience in:

  • Claims management
  • A basic understanding of medical terminology
  • Knowledge of relevant workers' compensation laws and return-to-work programs

COMMITMENT TO DIVERSITY
The University of Wisconsin values diversity and inclusivity as a source of strength and innovation. We appreciate the contributions of individuals from varied backgrounds and experiences.

WORKING CONDITIONS
This is a full-time, salaried position with potential telecommuting options available after a satisfactory probationary period. Candidates residing within the state of Wisconsin will be given preference.

COMPENSATION AND BENEFITS
Compensation for well-qualified candidates will fall within the range of $50,000 - $62,500 annually, based on education, experience, and qualifications. The University offers an excellent benefits package.