Workers Compensation Specialist

$70,000 - $85,000/Yr

Confidential - King of Prussia, PA

Full-time - Mid Level

King of Prussia, PA

About the position

The Workers' Compensation Specialist is responsible for managing and administering workers' compensation claims, which includes investigating work-related injuries, reviewing medical documentation, and ensuring compliance with regulations. The role acts as a liaison between the company, injured workers, and healthcare providers, aiming to minimize costs and facilitate timely return-to-work for injured employees.

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

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