Confidential - King of Prussia, PA

posted about 1 month ago

Full-time
King of Prussia, PA

About the position

The Workers' Compensation Specialist is responsible for managing and administering workers' compensation claims, ensuring compliance with regulations, and facilitating the return-to-work process for injured employees. This role involves investigating work-related injuries, reviewing medical documentation, and acting as a liaison between injured workers, employers, and healthcare providers to minimize costs and ensure timely treatment and recovery.

Responsibilities

  • Claims Investigation: Initiating contact with injured employees and supervisors to gather details regarding work-related accidents, reviewing incident reports, and verifying the validity of claims.
  • Medical Management: Reviewing medical records, authorizing necessary medical treatments, and monitoring treatment plans to ensure appropriate care is provided.
  • Communication: Maintaining contact with injured employees, employers, healthcare providers, and legal representatives to update them on claim status and address concerns.
  • Compliance: Staying updated on workers' compensation laws and regulations, ensuring all claims are filed accurately and within required timeframes.
  • Return-to-Work Coordination: Collaborating with employers and healthcare providers to develop a plan for injured employees to safely return to work with appropriate accommodations.
  • Claims Analysis: Identifying trends in claims data to identify potential risk areas and implement preventative measures.

Requirements

  • Maintain confidentiality
  • Strong analytical and problem-solving skills to evaluate claim details and make informed decisions.
  • Detail-oriented approach to manage complex case files and documentation.
  • Experience & Knowledge of workers' compensation laws and regulations in the relevant jurisdiction.
  • Understanding of medical terminology to interpret medical reports.
  • Understand, interpret and follow laws, ordinances, regulations and procedures.
  • Write various types of reports, plans and instructions.
  • Produce work products using computerized equipment and records.
  • Communicate effectively in oral and written form.
  • Manage a caseload and respond to requests in a timely manner.
  • Establish and maintain effective working relationships with all levels of staff.
  • Proficiency in Microsoft Office Suite and claims management systems.

Benefits

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Life insurance
  • Vision insurance
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