Worker's Compensation Specialist-USA

Apply only if you have extensive experience in Worker's Compensation in the USA

Job Description Worker's Comp Specialist

Job Summary

We are seeking a dedicated and experienced Worker’s Compensation Specialist. The individual ensures timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate investigation; ensures that the city is in compliance with applicable laws and regulations; provides training and guidance to claims coordinators in all departments.

Duties/Responsibilities:

Evaluates accident reports, ensuring the timely processing of medical bills and temporary total disability benefits; reviews medical reports, witness statements, department investigation results and other documentation. Compiles facts and data regarding accident reports and filed cases.
Maintains subrogation records and files for those incidents involving third parties; sends subrogation letters to third parties in an effort to obtain reimbursement of monies spent by the city for medical treatment, time loss, and awards and settlements paid; submits amounts paid for medical treatment and/or temporary total disability benefits to the State Attorney's Office in order to seek reimbursement in cases where criminal charges have been filed.
Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued; authorizes payment of medical bills and temporary total disability benefits upon receipt of proper documentation. Advises and/or assists departments in conducting investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation.
Reviews accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident; advises departments of trends in injuries and proper safety procedures that may result in reduction of injuries; provides departments with information that will aid in reducing accidents and improve safety.
Documents telephone conversations, witness statements, medical reports, accident investigation results and payment of medical bills; prepares summaries of medical reports; ensures that Illinois Industrial Commission forms are properly prepared and filed.
Attends seminars, conducts research and maintains liaison with individuals in the medical community and health care fields to keep abreast of current medical procedures and medications.

Required Skills/Abilities:

Working knowledge of the Workers' Compensation Act, city regulations and other applicable state/federal statutes and regulations.\
Working knowledge of medical terminology, body systems and/or impairments and their disabling effects.
Working knowledge of office procedures and files.
Ability to obtain facts that ensure that claims information is complete and accurate.
Ability to balance casework loads and efficiently process claims.
Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills.
Good judgment in interpreting medical facts presented by a physician and applying these facts in determining an individual's capacity to engage in gainful occupation.
Ability to read, assimilate and recall with marked proficiency facts, figures and descriptions, and to search for and obtain information.
Effective communication skills.
Ability to maintain satisfactory working relationships with co-workers, the general public and other agency personnel.
Working knowledge of the tenets of supervision and motivation of employees.

Education and Experience:

Requires knowledge, skill and mental development equivalent to the completion of 4 years of college with courses in medical terminology or anatomy and 3 years of experience in medical claims analysis or any equivalent combination of training and experience.