Impactful Workers' Compensation Claims Examiner

State of Ohio; Toledo (OH); On-site; USD 55,000 - 72,000; Full time

Job summary

Ohio Bureau of Workers' Compensation (BWC) seeks a highly organized claims examiner to manage a caseload of workers' compensation claims from Toledo and surrounding areas. The role requires coordinating with disability management, medical services, TPAs, employers, and injured workers to set return-to-work expectations.

Daily duties include investigations within required timeframes, processing various compensation types, responding to inquiries, and ensuring compliance with the Ohio Revised Code

Qualifications

• 36 months experience evaluating medical or public assistance benefits to determine eligibility
• Undergraduate core coursework in business, humanities, social & behavioral sciences
• Experience using Microsoft Office and specialized claims software

Responsibilities

• Manages a caseload of Workers’ Compensation claims: coordinates & collaborates with internal & external stakeholders to set return to work expectations.
• Performs initial/subsequent claims investigation & determination within prescribed timeframes.
• Processes various types of compensation ranging from Temporary Total, Wage Loss, Permanent Partial, Living Maintenance, to Lump Sum Advancement; addresses follow-up requests.
• Responds to customer inquiries.
• Follows Ohio Revised Code and BWC policies and procedures.
• Communicates with legal representatives, employers, claimants, etc.

Skills

Claims Examination

Customer Service

Attention to Detail

Critical Thinking

Teamwork

Time Management

Written Communication

Education

Undergraduate core coursework in business, humanities, social & behavioral sciences

Tools

Microsoft Office

Workers' Compensation Claims Management System

Intrafin

FMS fraud system

Job description

Ohio Bureau of Workers' Compensation (BWC) seeks a highly organized claims examiner to manage a caseload of workers' compensation claims from Toledo and surrounding areas. The role requires coordinating with disability management, medical services, TPAs, employers, and injured workers to set return-to-work expectations.

Daily duties include investigations within required timeframes, processing various compensation types, responding to inquiries, and ensuring compliance with the Ohio Revised Code