Workers Compensation Specialist

Overview:
Aerotek has an immediate opening for a Junior Workers Compensation Specialist at the corporate office in Tempe, AZ. 

 

Job Summary:

Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek’s workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently. 

 

Essential Functions:

Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims.  Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses

Within the scope of authority, reviews and authorizes worker’s compensation settlement offers to be made by the TPA

Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate

Reviews costs associated with all claims handling and developing strategies to improve performance

Works with TPA to move claims toward closure

Partners with Safety, Human Resources and Corporate Legal to drive claims management

Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator

Coordinates the employee’s release to transitional duty with the Return-to-Work Specialist and the Field Office.

Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial

Initiate subrogation where appropriate with management’s authorization

Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions

Conducts bi-annual audits to ensure TPA is meeting their best practices requirements

Review reserves and provide authorization to TPA, where appropriate within authority

Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments

Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed

Participates in developing strategies to reduce claims frequency and severity

Establishes and maintains a file and diary on all open claims

Participates in communicating claims trends to Regional Safety Manager

Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process

Attends training sessions, conferences, and workshops to keep abreast of current practices, programs, and legal issues for the purpose of conveying and/or gathering information required to perform functions

Authority level for settlements up to $70,000

Authority level for reserves up to $80,000

Qualifications:

High school diploma and 3 years work experience in insurance, workers compensation claim management or risk management or 

Associate in Arts / Sciences and 2 years' experience in workers compensation, or risk management or related field or 

Bachelor's Degree with 2 years' work experience in insurance, workers compensation claims management or risk management

Ability to learn TPA system & generate requested reports