PN: 20068877 - Workers' Compensation Claims Specialist (Cincinnati)

State-of-Ohio; Springdale (OH); On-site; USD 30,000 - 43,000; Full time

Job summary

The Ohio Bureau of Workers’ Compensation (BWC) in Springdale, OH is seeking a Claims Examiner to manage a caseload of workers’ compensation claims. You will communicate with internal and external stakeholders to set return-to-work expectations and perform investigations to determine information necessary for claim management.

Responsibilities include processing TT, Wage Loss, PPD, Living Maintenance, and Lump Sum requests; responding to inquiries; and ensuring compliance with the Ohio Revised

Qualifications

• Manages a caseload of Workers’ Compensation claims
• Performs initial/subsequent claims investigation & determination within prescribed timeframes
• Processes compensation types ranging from Temporary Total to Lump Sum requests
• Responds to customer inquiries and follows Ohio Revised Code and BWC policies

Responsibilities

• Manages a caseload of Workers’ Compensation claims and coordinates with internal & external stakeholders to set return-to-work expectations.
• Performs initial/subsequent claims investigation & determination within prescribed timeframes: Contacts parties involved in claim process and determines information for management of claim.
• Processes various types of compensation including TT, Wage Loss, Permanent Partial, Living Maintenance, and Lump Sum when requested; handles referrals to IC of Ohio.
• Responds to customer inquiries and communicates with legal representatives, employers, claimants, etc.

Skills

Claims Examination

Job description

All job postings will expire at 11:59 PM Eastern Time on the application deadline.

Organization

Workers' Compensation

Work Location

135 Merchant St Suite 100

Springdale, OH 45246

Compensation

$26.54/hr

Schedule

Permanent - Full Time

Work Hours

Monday - Friday, 8:00a - 5:00p

Classified Indicator

Classified

Union

OCSEA

Primary Job Skill

Claims Examination

Who We Are

With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.

Our Culture

BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums and learn about how different perspectives can improve leadership skills.

Our Vision

Simplify the Ohio workers' compensation experience.

Our Mission

Serve every customer with relentless excellence.

Our Core Values

One Agency - We achieve more together. Personal Connection - We listen, understand, and care. Innovation - We embrace change to drive better outcomes.

What Our Employees Have to Say

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

What You’ll Do

• Manages a caseload of Workers’ Compensation claims: Communicates, coordinates & collaborates with internal & external stakeholders (e.g. Disability Management Coordinator [DMC], Medical Service Specialist [MSS], Managed Care Organization [MCO], Employer Management [EM] team, Safety & Hygiene, injured workers, employers, Third Party Administrators [TPA] & rehabilitation personnel) in order to set return to work expectations.
• Performs initial/subsequent claims investigation & determination within prescribed timeframes: Contacts parties involved in claim process; completes investigation during initial claim development to determine information pertinent to management of claim (e.g., jurisdiction, coverage, causality, compensability, claim data accuracy, current work status of claimant, job description, salary continuation, physical demands of job, & work history of claimant).
• Processes various types of compensation ranging from Temporary Total (TT) Compensation, Wage Loss, Permanent Partial and Percentage of Permanent Partial, Living Maintenance, to Lump Sum Advancement requests; addresses subsequent requests by parties to claim via due process notification, investigation, BWC orders & referrals to the Industrial Commission (IC) of Ohio.
• Responds to customer inquiries.
• Follows Ohio Revised Code and BWC policies and procedures.
• Communicates with legal representatives, employers, claimants, etc.

Additional Information

EEO & ADA Statement

The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order. The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request reasonable accommodations related to disability, pregnancy, or religion, please contact the ADA mailbox [e-mail].

Transportation

Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.

Educational Transcripts

For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.

Background Check

Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.