Workers Compensation Administrator II administers the workers' compensation program for an organization. Implements a consistent process for recording, investigating, and reporting workers' compensation claims complying with laws and regulations. Being a Workers Compensation Administrator II prepares and submits required reporting and documentation to OSHA, state and local agencies, and other entities. Monitors all claims and liaises with the employees, managers, insurance representatives, union representatives, medical staff, and attorneys involved with a case. Additionally, Workers Compensation Administrator II communicates case status details and necessary information to involved parties, including notifications of hearings, outcomes, return to work, or restrictions. Performs periodic reviews of overall cases to identify trends. Maintains up-to-date knowledge of all regulations and laws for reporting workers' compensation. May coordinate or assist with safety programs focused on injury prevention or facilitate accommodations for workers. May require a bachelor's degree. Typically reports to a manager. The Workers Compensation Administrator II occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Workers Compensation Administrator II typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)
Acuity is seeking a Workers’ Compensation Claim Representative to investigate and resolve claims with empathy, passion, and a sense of urgency. Acuity looks to our Workers’ Compensation Claim Representatives to handle the entire claim from the investigation, to the determination of coverage and liability, to disposition including litigation if necessary.
This position is open to remote applicants within Acuity's operating territory. Candidates licensed or residing in Idaho are strongly encouraged to apply.
Internal Deadline to Apply: Thursday, June 13th.
ESSENTIAL FUNCTIONS:
Understand and consistently apply customer service concepts and requirements.
Conduct thorough initial investigations to determine coverage, compensability, subrogation, and fraud.
Understand basic anatomy and medical terminology.
Read and evaluate medical reports to determine extent of injury and treatment plans. Recognize, research, and analyze complex medical issues.
Implement pro-active direction and control with timely intervention and action planning.
Understand basic reserving concepts and adheres to company reserving guidelines.
Effectively utilize managed care cost containment programs, services, and vendors. Consistently provides direction to assure control of costs.
Recognize and aggressively pursue all potential subrogation recovery opportunities.
Understand and consistently apply legal and statutory concepts of the applicable jurisdiction.
Provide consistent meaningful file documentation with effective use of the queue and calendar system.
Demonstrate superior communication skills in all aspects of the position. Place emphasis on meaningful correspondence and effective customer service interactions.
Conduct Claim Reviews independently with Insureds and Agents.
Demonstrate interest and ability to handle increasingly more complex issues.
Regular and predictable attendance.
Perform other duties as assigned.
EDUCATION:
College degree or equivalent
EXPERIENCE:
Minimum 2-3 years of experience in handling Workers’ Compensation claims preferred
OTHER QUALIFICATIONS:
Thorough understanding of personal computing, typing skills, technology and use of mobile devices.
Basic understanding of medical terminology and treatment, physiology, and anatomy.
Understanding of WC statutes and case law.
Someone who has demonstrated sustained excellence over a prolonged period of time.
Excellent written and verbal communication skills.
Independently conducts claim reviews & service presentations to agents and potential new insureds.
Independently handles litigated claims including attending prehearings, mediations, and hearings.
Has served as a mentor for a new employee or willingness to do so by volunteering with job shadowing and training activities.
Participates in or conducts a training session for unit and/or department.
Has accompanied SIU on field claim investigations.
Ability and willingness to provide quality customer service.
Must be a self-starter, take on and create new opportunities.
Ability to work both independently and in collaboration with others.
Proven organizational and time management skills.
This position is classified as exempt.
The salary range for this position is $80,000-$120,000 annually. This salary range is an estimate and the actual salary will vary based on applicant’s education, experience, knowledge, skills, and abilities.
We are an Equal Employment Opportunity employer. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We are an Equal Employment Opportunity employer. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.