Worker's Compensation and LOA Specialist

Job Description

Job Description

Responsibilities

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Radiology Forward . With dynamic cross-training and advancement opportunities in a team-focused environment, the core of our success is its people with the commitment to a better healthcare experience. When you join us as a Worker’s Compensation and LOA Specialist, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes.

You Will :

• Reports new claims to insurance carrier.
• Ensures timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate scope of investigation for human resources and safety departments.
• Ensure that HR and legal department is aware of all depositions, trial or legal proceeding dates.
• Assists in coordinating medical treatment for all newly reported workers compensation
• Providing accurate information to injured employee on seeking medical care within the medical provider network (MNP) and filling prescriptions
• Conducts initial investigations over the phone by interviewing injured employee, site contacts, and witnesses upon receipt of new claims / incident reports. If there are any apparent red flags, notify Workers’ Compensation Manager, insurance carrier and HR team.
• Coordinates and facilitates claim process by acting as a liaison between the insurance carrier / third party administrator, medical provider, site management and injured employee
• Maintains effective communication with employee, insurance carrier, managers, supervisors, and Work Comp Manager
• Audit claims to ensure insurance carrier are delivering quality support to injured employee; provide feedback to senior HR management where deficiencies or issues are identified.
• Facilitate management of individual WC cases by providing insurance carrier with case information, including job descriptions, wage histories and personnel information
• Follow up with employees regarding their work status, conferring with manager, third-party administrator, and healthcare provider as needed
• Responsible for managing WC leave of absence FMLA / ADA.
• Ensure clear, timely communication to appropriate regional HR generalist or Director and site management regarding WC leaves.
• Interactive process under the Americans Disability Act (ADA) and Fair Employment Housing Act (“FEHA”) :

You Are :

To Ensure Success In This Role, You Must Have :