Description

• May serve as backup for Substance Abuse policy administration
• May assist with training for other related areas of responsibility
• Assists in developing legal strategy for each litigated case
• Helps maintain documentation, legal evidence, and other related file administration
• May serve as a back-up for FMLA, ADA, and disability related claim procedures and claims management issues
• Prepares and participates in strategic claim resolution meetings
• Assists with monitoring federal and state leave regulations and with working with vendors and plants to implement any necessary updates to existing procedures
• Ensures that all claims are reviewed for appropriateness of acceptance or denial
• Provides guidance and related training to plant personnel with work comp responsibilities
• Advises the field in transitional and long-term return-to-work strategies
• May assist with policy updates for related areas of responsibility
• Ensures that the claim managers/TPA pay medical bills and other related invoices promptly
• Produces quarterly trend reports and other related reports as requested
• Advises the field in identifying and maintaining quality medical providers
• Provides assistance to the field regarding medical management and return to work
• Assists in the identification of legal counsel with assistance from the claim managers/TPA
• May serve as backup for other various safety related program administration
• Trains new plant HR/safety personnel, including acquisitions, on related leave of absence procedures
• Assists with updating documentation and communication associated with related leaves of absences
• Monitors claim activity to ensure timely and accurate delivery of benefits
• Reviews claim data to ensure that claims are managed, paid, and resolved according to service criteria
• Assists with providing information to TPA/legal counsel in response to subpoena requests
• Acts as a liaison between injured worker and TPA/carrier
• Serves as primary contact for the field operations on WC related claim procedures and claims management issues
• Advises the field and claim managers/TPA in investigating aspects of serious or questionable claims
• Maintains updated knowledge of state comp laws or other legal changes impacting areas of responsibility

Requirements

• Verbal and written skills with the ability to communicate at all levels within the organization
• Bachelor’s degree or equivalent experience in a related field
• Ability to maintain and safeguard confidential information
• Ability to travel as required
• Demonstrated ability to use computers and related business software and experience with advanced excel or other report writing programs
• Ability to understand, analyze, and communicate financial information as a management tool
• Interpersonal and problem-solving skills
• Ability to coordinate and prioritize case load
• Formal, working knowledge of claims management protocol and related employment law
• Ability to solve problems and apply knowledge and education in complex situations
• Some knowledge and understanding of medical terminology

Benefits

Training + Development

Interview process

Visa Sponsorship

Security clearance