What are the responsibilities and job description for the Work Comp Coordinator position at Les Schwab Warehouse Center, LLC?
Job Description:
POSITION SUMMARY:
Responsible for the management of various aspects of Company workers’ compensation programs including claim intake & set-up, medical claim management, claim resolution strategy, Return-to-Work management, TPA oversight, claim cost allocation, payment processing and serving as a liaison with Store management on workers’ compensation claims.
PRIMARY RESPONSIBILITIES:
25% - Third Party Administrator (TPA) & Les Schwab WC Program Management: Review, analyze and approve TPA billed fee invoices for payment, review monthly claim closure reports, aged pending claim reports, nurse line utilization and invoice processing, identify subrogation potential, review monthly paid loss reports, verify accuracy of monthly service fee chargebacks to Stores (Rebill Process). Collect, review and process claim operations reports, including daily TPA invoice reports, , monthly time loss and new/closed claims reports, and track claim data in Riskonnect for future safety initiatives. Responsible for various tasks such as Company intranet site updates/management, medical provider panel updates and other administrative tasks as delegated.
30% - Return-To-Work Program Management (Claims with Modified Duty Work): Coordinate the injured employee return to work with Les Schwab store and operations management. Review injured worker’s physical restrictions and treatment plans with Store management to identify modified duty job opportunities and ensure modified duty jobs are within medical restrictions, collect and monitor updated work releases for any necessary adjustments of modified duty work. Prepare Job Analysis/Offer Letters and light duty job descriptions for employees and medical providers. Coordinate with medical providers upon receipt of signed modified duty job analysis and obtaining documentation required for managing return-to-work issues. Monitor updated work releases and communicate changes with management and TPA. Extract employee data from Company’s Workday HR data system as needed for claim management.
30% - Claim Intake, Claim Management & Administration: Manage daily intake of new claims through the electronic claim reporting process. Triage claims with Store management and set-up claim files in Riskonnect Risk Management Information System. Liaison between TPA and employee to ensure timely reporting to TPA, insurance carrier and/or state agency, initial treatment with preferred providers, clinical consultation (nurse line) and issuance of correct state claim reporting forms. Closely manage all Medical Only claims to ensure claims are being processed in accordance with Les Schwab standards for service, communication, payments, cost containment and risk mitigation. Monitor medical only claim reserves and provide recommendations for reserve changes as needed. Review TPA claim handling recommendations, treatment plans and monitor claims for claim closure strategy. Communicate claim status to Department management for future claim management strategy recommendations. Input and manage claim data in Riskonnect. Prepare claim causation, disposition and paid loss reports as needed for the Risk Services management team. Work with TPA adjusters to review claims for acceptance, treatment approvals and compensability in conjunction with State workers’s compensation laws & standards.
5% - Manage the Oregon EAIP cost recovery program, identify files with recovery potential, prepare files for invoice processes and work with assigned legal counsel for recovery of costs from the State.
5% - Process recoveries in connection with Les Schwab Accounting team and post recoveries in Company RMIS for credit.
5% - Provide weekly/monthly status updates to the Human Resources ADA Committee for recovery status, treatment plans and full duty work feasibility.
MINIMUM REQUIREMENTS:
Educational/Experience Requirements: Associates Degree or equivalent preferred. 2 years workers’ comp experience and/or Human Relations experience preferred.
Required Technical Skills/Knowledge: Knowledge of workers’ comp laws and regulations in applicable states; good knowledge of MS Word and Excel.
General Knowledge and Abilities: Ability to work effectively and independently without close supervision; excellent oral and written communication skills, presentation skills and ability to lead training sessions; ability to multitask, prioritize and utilize time effectively; ability to establish and maintain cooperative working relationships; excellent analytical, problem solving and decision making skills; regular attendance.
PHYSICAL REQUIREMENTS: Regular sitting and fingering.
WORK ENVIRONMENT: office/non-manual.
EXPOSURE TO CONFIDENTIAL EMPLOYEE INFORMATION: HIPAA ; PCI ; Payroll
BENEFITS:
Quarterly profit-sharing bonus
Medical, dental, vision, and life insurance
Company-funded retirement plan - no cost to employee
Paid holidays
Paid time off
Hybrid arrangements available (3-4 days in office 1-2 days from home)
Tuition Assistance
Employee discount
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions/primary responsibilities. This job description is not all inclusive and is subject to change. Additional duties, responsibilities, and tasks may be assigned, as necessary. Employment remains “AT WILL” at all times.