Workers Compensation Specialist- Full Time

OSS Health; York; On-site; GBP 30,000 - 40,000; Full time

Job summary

A leading healthcare provider is seeking a full-time Workers Compensation Specialist in York. The role involves facilitating case management for injured workers, ensuring timely communication with insurers, and maintaining necessary documentation. Successful candidates will possess strong problem-solving, organizational, and communication skills, along with relevant experience in Workers’ Compensation or a related field.

Qualifications

• At least one year of Workers’ Compensation or related experience required.
• Effective written and verbal communication skills.
• Basic knowledge of medical terminology.

Responsibilities

• Facilitates case management for injured workers currently being treated.
• Maintains contact and communicates with claims adjusters.
• Prepares for timely return to work by coordinating with all involved parties.

Skills

Problem-Solving

Communication

Analytical Skills

Organizational Skills

Customer Service

Education

High School diploma or equivalent

Associate degree in related field

Tools

General computer software

Job description

Workers Compensation Specialist- Full Time

Job Category: Clinic

Requisition Number: WORKE003357

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• Posted : May 29, 2025
• Full-Time
• On-site

Locations

Showing 1 location

1855 Powder Mill
York, PA 17402, USA

Description

JOB SUMMARY:

Under the direction of the Occupational Health SUPERVISOR

SCHEDULE:
Office is open 8-5

Remote work one day per week once FULLY trained

SCHEDULE:

Monday - Friday
8- 4:30

TRAVEL:

Weekly travel to remote sites:
Hanover, one day per week

QUALIFICATIONS AND EDUCATION:

Education:

• High School diploma or equivalent required.
• Associate degree in related field or equivalent level of experience strongly preferred.

Qualifications:

• General computer software knowledge required.
• Excellent organization, problem-solving and communication skills required.
• Excellent analytical and customer service skills to facilitate the resolution of case management problems.
• Effective organizational and planning skills
• Effective written and verbal communication skills
• At least one year of Workers’ Compensation or related experience required.
• Basic knowledge of the needs of the employer and insurer.
• Basic knowledge and understanding of medical terminology.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Facilitates case management for injured workers currently being treated by OSS Health.
• Possible patient interaction if the patient has an issue that has arisen and they are in the clinic
• Receives claim, confirms policy coverage and acknowledgment of the claim.
• Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case (Employers, NCM) necessary for case management of the injured worker/disabled individual. Including facilitating communication with companies in the area to promote OSS as a panel provider for work related injuries. Maintain panel of WC companies.
• Handles claims consistent with client's policies/panels, procedures and "best practices" and in accordance with any statutory, regulatory and ethics requirements.
• Facilitate timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured workers, employer, insurer, and physicians.
• Obtains out-of-state authorizations for treatment prior to appointments.
• Maintain up to date and accurate documentation and records on claims.
• Communicates with AR department regarding denials and changes within accounts for WC patients.
• Ensuring confidentiality and professionalism is maintained when dealing with sensitive and confidential information.
• Returns voicemail, email, and any other inquiries in a timely manner.
• Partners with and supports other departments that work with and in conjunction with the Workers Compensation Department
• Exercises sound, independent judgment in decision-making.
• Render opinions regarding treatment plan, outcome, and problem areas, and makes recommendations to facilitate case management goals to include RTW.
• Identify opportunities for cost control, process improvements and quality improvements related to customer service.
• Report findings and concerns to Senior Management along with timely and logical recommendations on how to improve unfavorable situations or complaints and how to reduce or avoid unfavorable conditions.
• Other duties as assigned.

SUPERVISORY RESPONSIBILTIES:

No direct reports to this position.

LANGUAGE SKILLS:

Ability to communicate effectively, in English, with staff, peers, physicians and the public both verbally and in writing.

PHYSICAL DEMANDS:

Work generally performed in an office setting during standard day shift hours. The noise level is typically moderate. Work may occasionally be fast paced and require dealing with multiple priorities and time constraints. Work requires some physical activity with periods of prolonged sitting. Incumbents must have the ability to transport self to and from various locations throughout the department and office locations. Must be able to operate computers and other equipment used to perform this job's essential functions. Light physical effort required; some standing, walking, bending, reaching, and stooping. Able to maintain a pleasant and courteous demeanor under all circumstances.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT:

Climate controlled environment with occasional periods of being outside.

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

Qualifications

Experience

Preferred

Basic knowledge of the needs of the employer and insurer.

At least one year of Workers’ Compensation or related experience required.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.