Workers Compensation Job Description
Workers compensation
provides daily assistance to management staff, teammates, claims adjusters, insurance brokers, and defense counsel by answering claims-related questions or concerns in the administration and management of claims, return-to-work issues, and other claims matters.
Workers Compensation Duties & Responsibilities
To write an effective workers compensation job description, begin by listing detailed duties, responsibilities and expectations. We have included workers compensation job description templates that you can modify and use.
Sample responsibilities for this position include:
Responsible for compliance with relevant laws, regulations, policy requirements, industry standards and company policies
Direct medical providers, nurse case managers, adjusters, emergency rooms, and Fox Clinic for work related injuries
Investigate new claims, authorize and arrange medical treatment, develop defenses if claim is heading for litigation
Communicate with injured worker, supervisors, Human Resources and Labor regarding benefits, doctor appointments, off work, restricted work and return to work
Coordinate ergonomic evaluations with vendor and injured worker
Prepare job analysis for injured employee
Coordinate and attend FEHA Interactive Meetings between Employee and Human Resources
Supervise and troubleshoot Provider payments
Prepares monthly and quarterly Risk Management status reports ad hoc loss runs and other claim data analyses from the TPA’s system, company information and other sources
Investigating and taking recorded statements
Workers Compensation Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Workers Compensation
List any licenses or certifications required by the position: CCM, COHN, CPCU, CRRN, CDMS, SIP, AIC, PHR, WCCA, I.E.A
Education for Workers Compensation
Typically a job would require a certain level of education.
Employers hiring for the workers compensation job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Business, Education, Management, Legal, Law, Technical, Business/Administration, Associates, Supervision, Human Resources
Skills for Workers Compensation
Desired skills for workers compensation include:
Claim file process through presentation of actions and responses to client questions
Accepted industry standards and practices Computer experience with related claims and business software
Regulations
Disability duration
Medical management practices and Social Security and Medicare application procedure as applicable to line of business
Offsets and deductions
Accepted industry standards and practices
Social Security and Medicare application procedure as applicable to line of business
Claims management processes and procedures for multiple product lines
Team member related functions
Desired experience for workers compensation includes:
Determining compensability
Handling all aspects of litigation and subrogation and report to client and excess carriers
Responsible for time sensitive decisions to meet regulatory mandates
Communicates with internal external clients in a clear, concise manner, to appropriately administer benefits
Collect and regularly report on statistics regarding FMLA cases
Serves as the contact for all worker's comp personnel for all inquires related to referrals and/or admission into the rehabilitation hospital
Workers Compensation Examples
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Workers Compensation Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of workers compensation. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation
- Develops strategies to grow market share in core business lines in worker's comp industry and key insurance companies
- Creates quarterly goals and objectives and submits to supervisor.Serves as an advocate and educates worker's comp companies and insurance industry on IRF
- Attends local, regional and national conferences as appropriate
- Prepare and distribute LOA reports
- Maintain monthly metric reporting on LOA and WC
- Monitor leave tracking process for accuracy and timely notifications
- Tracks and answers inquiries for LOA benefit billing process and assists in the administration as needed
- Prepare short-term disability forms
- Assist with establishing and communicating light duty assignments
- Assist with ACA data validation
Qualifications for workers compensation
- Workers Compensation experience a plus
- Minimum of 2 years’ experience in healthcare billing office
- Proficiency with Microsoft Office applications, especially Excel, Internet Explorer/Chrome
- Perform special projects as assigned by Total Rewards team members
- Working knowledge of Ultipro a plus
- Understanding of general HR practices and processes
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Workers Compensation Job Description
Job Description Example
Our growing company is looking to fill the role of workers compensation. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation
- Work with members of Risk Optimization and ESIS to calculate and communicate the monthly reserve change charges for each respective Georgia-Pacific business
- Maintain the Georgia-Pacific Workers’ Compensation database
- Verify that the liabilities recorded on the individual business ledgers are accurate and provide updates/guidance as needed
- Prepare the journal entries for Corporate-related workers’ compensation activity
- Prepare monthly and quarterly reporting for internal management reports and the external financial statements
- Prepare Corporate monthly balance sheet account analysis to remain in compliance with internal controls
- Assist in the final implementation of the new accounting reporting tool.Assist the Tax Department in reporting activity to the IRS
- Assist E&Y in the annual audit
- Provide input and recommendations for process improvements by respectfully challenging historical practices
- Identify and resolve problem issues as it relates to the TRD program
Qualifications for workers compensation
- Previous experience in Worker's Compensation or experience as an adjuster required
- Must be a highly motivated and proactive individual
- Knowledge of the States Workers' Compensation system principles, statutes and judicial protocol
- Experience with Microsoft Office Suite (MS Word – document creation, formatting and editing and Excel – spreadsheet creation/editing, pivot tables, data manipulation/analysis and formulas creation )
- Clear understanding, aptitude and desire for problem solving, learning new systems and improving processes through automation
- Experience with Microsoft Access query preparation
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Workers Compensation Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of workers compensation. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for workers compensation
- Responsible for managing all aspects of each claim, including informal hearings and small claims litigation and maintaining a high level of productivity, confidentiality and customer service
- Work with the Special Investigations Unit to resolve and negotiate settlement
- Coordinates with loss prevention programs to reduce accident frequency
- Oversee the day to day operations in regards to management of the Steward Worker's Compensation claims and insurance program including managing internal and external contracts (TPA, Counsel, Providers)
- Provide strategic direction and recommendation to leadership in regard to improving the performance of the workers compensation program
- Develop, recommend and implement workers' compensation policies and procedures that mitigate claims and premium costs
- Develop and recommend loss prevention programs to Employee Health and Hospital Leadership
- Coordinate with Employee Health and Environmental Safety departments to lower the rate of workers compensation related claims and expense
- Manage insurance placement to ensure coverage that is comprehensive and cost efficient
- Oversee and ensure an efficient records maintenance system for workers' compensation claims and related information, data and activities in collaboration with the TPA
Qualifications for workers compensation
- Occasional standing and occasional lifting minimum of 25 lbs
- IEA, SIP required
- ARM preferred
- Working knowledge of regulatory agencies
- Possesses an eagerness to learn, develop and work independently in a positive, results-oriented working environment
- Certification in Industrial Ergonomics
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Workers Compensation Job Description
Job Description Example
Our company is searching for experienced candidates for the position of workers compensation. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for workers compensation
- Participate in budget preparations and monitor expenditures
- Supervises, hires, and reviews work of unit’s managers and attorney
- Leads staff in the review of work processes and the introduction of new initiatives
- Serves as the subject matter expert on claims administration
- Reviews incoming cases with case managers and other employees in the office to make decisions on paying or denying claims to ensure that eligible claimants receive benefits in a timely manner pursuant to applicable law
- Oversees legal activities and represents the City at Department of Industrial Accidents (DIA) and state courts in all phases of litigation
- Signs letters directing payment, modification or termination of workers' compensation claims
- Prepares lien letters in cases involving a third-party action
- Oversees communication with City departments regarding the progress and outcome of active cases and the coordination of return to work efforts
- Acts as liaison between Benefits, Payroll, Legal, and Safety to coordinate services, improve workflow and streamline the processing of claims
Qualifications for workers compensation
- Advanced understanding of terms and concepts relevant to Workers compensation practices in multiple states
- Meets with OHR senior management to discuss initiatives and advocate for the program
- Works with the Department of Information Technology to insure state of the art IT support to the workplace processes and reporting mechanisms of the Workers’ Compensation Unit
- Completes and files all necessary documents with the appropriate state agencies to ensure legal compliance with all applicable laws to allow the City to operate a preferred provider arrangement
- Oversees the maintenance of unit’s records and files
- Oversees the preparation of data metrics and reports of unit’s activities to determine patterns in workers' compensation cases including time from receipt of claims to determination and first check, length of litigation, length of absences, types of injuries by department
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Workers Compensation Job Description
Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of workers compensation. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for workers compensation
- Oversees the preparation and administration of the annual budget
- Drafts annual audit report and forwards to the Corporation Counsel
- Participates in special projects as assigned and prepares reports as requested
- Underwriting new business and renewals, and providing quotes in a timely and professional manner within agreed underwriting parameters and service standards
- Relationship development, including visitations, with a variety of brokers including internationals
- Responds timely to all electronic, written and verbal communications
- Establishes immediate contact with Policyholders, claimants and medical providers
- Handles workers' compensation claims, including fatalities
- Resolves coverage questions, exercising discretion and independent judgment, and in compliance with applicable workers' compensation law
- Coordinates activities with a rehabilitation specialist on seriously injured claimants and refers special risk situations to commercial underwriting
Qualifications for workers compensation
- At least five years of full-time, or equivalent part-time, experience in the workers’ compensation field, preferably in a self-insured employer worker’s compensation program, of which two years must have been in a supervisory or managerial capacity
- Member in good standing of the Massachusetts Bar Overseers
- Knowledge of the jurisdiction, functions and procedures of the Department of Industrial Accidents and state courts
- Demonstrated knowledge of the Workers' Compensation law (MGL c
- Knowledge of Microsoft Office products or similar software
- Ability to direct a city-wide program, establish priorities, and supervise staff