Workers’ Compensation Specialist
turner
Position Description: Oversee insurance carriers and Third-Party Administrators (TPAs) in their management and handling of affiliated clients’ Workers’ Compensation claims in an assigned geographic region of the country based upon program and compliance regulations
Essential Duties & Key Responsibilities:
Oversee assigned workers’ compensation case portfolio of minor to complex claims in assigned geographic region.Leverage knowledge of workers’ compensation policy and manage incidents, and dispatch nurse case managers as necessary. Collaborate closely with Risk Management leadership on workers’ compensation claims, process, and procedures to ensure integrated program.Serve as resource for injured employees and inform of workers’ compensation process and procedures.Report workers’ compensation claims to carriers and Third-Party Administrators (TPAs), including notification of questionable claims. Facilitate proactive identification of claims with opportunities for early Return to Work and light duty Return to Work program, as needed.Evaluate and respond to Reserve and Settlement Consultations within given authority, escalate consultations above scope authority to appropriate leadership.Maintain diary for open claims and document specific claim related activities in Risk Management information system.Work with carriers, TPAs, and Defense Counsel to develop mitigation strategies for Owner Controlled Insurance Program (OCIP) that result in cost savings to the claim, ensure aggressive strategy is developed on litigated claims, and bring claims to timely resolution.Collaborate with General Liability team to develop mitigation strategies and facilitate most economic global resolution of Contractor Controlled Insurance Program (CCIP) claims.Attend hearings and mediations on as needed basis.Ensure avenues for potential claim recovery are identified and pursued and manage lien recovery on case-by-case basis.Participate in claims review process and monitor claims handling process by carriers and TPAs; provide direction to ensure compliance with best practices and special handling instructions.Oversee and hold vendors and defense firms accountable for adherence to standard protocols, agreed to service instructions, and litigation management guidelines. Update instructions and guidelines and provide recommendations to appropriate leadership.Partner with Safety team and onsite medics on initiatives that support worker wellness and post-injury care.Participate in CCIP kickoff meetings and jobsite walkthroughs, attend Claims, Safety and Operations meetings to monitor current and anticipated project risks and report on claims status for specific projects. Maintain and foster relationships with carriers and TPAs claims teams. Assist with claim data analysis and claim performance reports. Collaborate with HR and Payroll departments for completion of required Workers’ Compensation Jurisdictional Forms. Support audits related to workers’ compensation claims. Remain current on Workers’ Compensation laws and regulations, industry trends, and case law within assigned jurisdictions. Other activities, duties, and responsibilities as assigned.*This is a remote position with some travel required; however, the ideal candidate will be based in the Northeast region to align with business needs.*
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