Human Resources, Workers Comp
Community Memorial Health System - Ventura, CA
posted 7 months ago
About the position
The position reports to the Director of Occupational Health Services and is primarily responsible for managing Workers' Compensation, disability, and loss prevention activities for Community Memorial Health System (CMHS) and its affiliates. This role acts as a vital resource for the CMHS leadership team and employees regarding workers' compensation issues, ensuring that all parties are informed and compliant with relevant guidelines and policies. The individual will coordinate activities among employees, supervisors, medical providers, third-party administrators, legal counsel, Human Resources, Payroll, and other agencies involved in leave of absences and California Workers' Compensation. A key focus of this role is to minimize the risk of job-related accidents and monitor operations to eliminate hazardous activities, thereby promoting Occupational Health and Workers' Compensation safety awareness. In addition to these responsibilities, the position involves performing general administrative and office support duties on assigned projects and other work as necessary. Essential functions include acting as a resource for the CMHS leadership team and employees regarding workers' compensation guidelines, policies, and processes. The individual will identify claims requiring additional attention and initiate interventions to address the circumstances of those claims. Proactive communication and education with managers and employees regarding workers' compensation legislation and policy interpretation are crucial aspects of this role. The position also requires timely correspondence with various stakeholders, including supervisors, employees, physicians, and legal counsel, regarding workers' compensation claims. The successful candidate will be responsible for submitting claims to the third-party administrator within three business days, ensuring completeness, and utilizing a medical claims management approach to coordinate medical treatment and return-to-work processes. The role also includes assisting managers and supervisors with the electronic tracking system for leave of absence, escalating sensitive issues to Human Resources and Occupational Health, and maintaining payroll records for employees on workers' compensation. Additional duties involve processing employee terminations, performing clerical tasks, and participating in Occupational Health annual programs. The individual will facilitate leave of absence approvals, return-to-work processes, and job accommodations, ensuring proper documentation is completed and updated in electronic systems. Furthermore, the role includes keeping records of work safety-related incidents and proposing corrective actions, collaborating with managers to monitor compliance, and assisting with COVID-19 communications.
Responsibilities
- Acts as a resource to the CMHS leadership team and employees regarding workers' compensation guidelines, policies, and processes.
- Identifies workers' compensation claims requiring additional attention and initiates interventions to address the circumstances of the claim.
- Provides proactive communication and education with managers and employees regarding workers' compensation, including education on state and federal legislation.
- Corresponds in a timely manner with supervisors, employees, physicians, medical clinics, investigators, legal counsel, and the third-party administrator regarding claims.
- Prepares correspondence to be sent to employees in accordance with policies.
- Submits workers' compensation and disability claims to the third-party administrator within three business days and reviews them for completeness.
- Utilizes a medical claims management approach to coordinate medical treatment, return to work, and leave of absences related to workers' compensation.
- Provides assistance and instruction to managers regarding the leave of absence electronic tracking system.
- Escalates difficult or sensitive medical issues to Human Resources and Occupational Health RN.
- Ensures paid leaves and transitional work banks are appropriately accessed.
- Assists employees with questions regarding workers' compensation benefits and payroll coordination.
- Maintains and edits payroll records for employees on workers' compensation.
- Processes employee terminations and ensures timely checks and additional documents are processed as necessary.
- Performs clerical duties such as filing, photocopying, and running errands to maintain department operations.
- Participates in Occupational Health annual programs.
- Facilitates workers' compensation leave of absence approvals, return to work, and job accommodations.
- Ensures proper documentation is completed and electronic systems are updated with appropriate statuses.
- Keeps records of work safety-related incidents and proposes corrective actions.
- Collaborates with managers to monitor compliance and identify safety issues.
- Assists with COVID-19 calls and provides email communication for return to work processes.
Requirements
- High School diploma or equivalent (GED).
- Five (5) years' experience in Workers' Compensation Claims Management.
- Knowledge of State and Federal labor laws and regulations.
- Three (3) years' experience in Human Resources or Occupational Health in an acute health care environment within the last five years.
- Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.
- One (1) year experience in a medical or business office.
Nice-to-haves
- Bachelor's Degree in Business Administration.
- Ten (10) years' experience in Workers' Compensation Claims Management.
- Five (5) years' experience in Human Resources or Occupational Health.
Benefits
- Competitive Pay
- Shift Differentials
- In-House Registry Rates
- Fidelity 403(b) Retirement Plan
- Paid Time Off
- Medical (EPO/PPO), Dental, & Vision Insurance Coverage
- Voluntary Worksite Benefits
- Employee Assistance Program Available 24/7 (EAP)
- Tuition Reimbursement
- Public Service Loan Forgiveness (PSLF)
- Recognition programs
- Employee service recognition events
- Home, Retail, Travel & Entertainment Discounts
- National Hospital Week and National Nurses Week celebrations
