Workers' Compensation Specialist

Posted 2 days ago

hirequestGoose Creek (SC)

SENIORITY

Senior

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About the role

Worker's Compensation Specialist This is an in-office position - local candidates only Monday - Friday 8:00 am - 4:30 pm
Position Summary: Under general direction, ensures timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate investigations are completed. Duties/
Responsibilities: Evaluates accident reports, ensuring the timely processing of medical bills and temporary total disability benefits; reviews medical reports, witness statements, department investigation results, and other documentation. Compiles facts and data regarding accident reports and active claims. Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued; authorizes payment of medical bills and temporary total disability benefits upon receipt of proper documentation. Advises and/or assists departments in conducting an investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation. Reviews accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident; advises departments of trends in injuries and proper safety procedures that may result in a reduction of injuries; provides the department with information that will aid in reducing accidents and improve safety. Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills. Prepares summaries of medical reports. Required Skills/Abilities Working knowledge of the Workers' Compensation Act and other applicable states/federal statutes and regulations. Ability to obtain facts that ensure that claims information is complete and accurate. Ability to balance casework loads and efficiently process claims. Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills. Good judgment in interpreting medical facts presented by a physician and applying these facts in determining an individual's capacity to engage in gainful occupation. Comfortable interacting with and emailing branches, doctors, medical facilities, witnesses, adjustors, and attorneys.

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