Workers Compensation Specialist

This is a fully remote position, open to applicants in New York.

📋 Description

• Oversee the administration of employee workers’ compensation claims for various companies across different states.

• Manage relationships with insurance carriers, vendor partners, and other service providers related to claims.

• Assist in Loss Control and Safety Training initiatives.

• Develop, formulate, and coordinate activities related to claims to reduce workers’ compensation risks and claims.

• Ensure compliance within TAG and the supported practices.

• Facilitate activities related to workers’ compensation claims and devise strategies to enhance claim management processes.

• Review and manage incident reports from employees and patients from the initial report to resolution.

• Assess whether claims need to be reported to insurance carriers.

• Manage payroll and claims reporting for monopolistic states.

• Clearly explain the claims process to employees.

• Collaborate with HR, medical providers, management, and third parties to coordinate return-to-work programs.

• Direct third parties for prompt and cost-effective claims resolution.

• Process treatment and billing for injured workers.

• Collect claims data and information and facilitate reviews of claims.

• Complete annual Bureau of Labor Statistics reporting for states.

• Manage updates and retention of workers’ compensation policies based on changes within entities.

• Maintain internal claims files.

• Compile, review, and analyze reports to identify trends.

• Report relevant Urgent Care events and claims to insurance carriers.

• Create and maintain records in information systems or databases.

• Build and nurture relationships with third parties, insurance carriers, outside legal counsel, and other claims-related entities.

• Assist with safety training and provide insights on safety matters.

• Support risk-related projects and initiatives while promoting strategies for loss prevention.

⛳️ Requirements

• Preferred college degree or more than two years of experience in claims management.

• At least 2 years of experience as a claims analyst, administrator, or in a comparable role.

• Capability to lead a multi-state program with employees located in different sites.

• Experience in customer service.

• Ability to investigate and manage the claims process effectively.

• Proficient in Microsoft Office.

• Familiarity with Risk Management Information Systems (RMIS).

• Strong organizational abilities.

• Excellent written and verbal communication skills.

• A history of implementing programs that positively affect claims costs is advantageous.

• Technical and professional knowledge in claims management and loss prevention.

• Adaptability to changing priorities.

• Strong collaborative and effective communication skills.

• Initiative, problem-solving, analytical, and results-oriented mindset.

• Integrity and honesty.

• Capacity to maintain confidentiality.

• Ability to read and interpret regulatory rules and regulations.

• Strong presentation abilities.

• Effective time management skills.

🏝️ Benefits

• Bonus incentives.

• Comprehensive benefits package.

• Paid time off.

• Health insurance.

• Dental insurance.

• Vision insurance.

• 401(k) savings plan with matching contributions.