Worker's Compensation & Leaves Specialist

Day & Ross; York (York County); On-site; USD 65,000 - 90,000; Full time

Job summary

Day & Ross in York, PA seeks a Workers Compensation & Leaves Specialist to oversee claims life cycle, coordinate with TPAs and state agencies, and ensure compliance with state laws. You will review accident reports, initiate claims, and administer leave and short-term disability in collaboration with TPAs.

The role requires 3+ years of medical claims analysis, strong analytical skills, confidentiality, and excellent communication.

Qualifications

• 3+ years of experience in medical claims analysis or related field.
• Training in federal and state Workers’ Compensation compliance laws
• Knowledge of FMLA, ADA and related leave regulations
• Strong analytical and confidentiality skills
• Ability to liaise with TPAs and State Agencies

Responsibilities

• Collaborate with TPAs to ensure accurate application of policies.
• Initiate workers’ compensation claims with TPA.
• Facilitate state workers’ compensation cases when applicable.
• Review cases with TPAs/state agents and HR Partners.
• Evaluate accident reports and compile facts for reporting to TPA/state.
• Provide return-to-work information and coordinate accommodations.
• Oversee leaves and short-term disability with TPA.
• Stay current on leave laws (FMLA/ADA) and regulatory changes.
• Perform other duties as assigned.

Skills

HR compliance

Workers' compensation

Medical claims analysis

Communication skills

Attention to detail

Confidentiality

Multi-tasking

Education

HR/Related degree

RN designation

Tools

MS Office

HRIS

Job description

Job Description

You belong at Day & Ross.

Workers Compensation & Leaves Specialist

Full-time - Onsite

York, PA

Under the direction of the Manager, Pension & Benefits, NA, the Workers Compensation & Leaves Specialist will perform varied administrative and specialized tasks in support of the day-to-day administration of employee benefit programs, assist with various benefit related issues in accordance with established policies and regulations, while maintaining a very high degree of confidentiality. They will be liaising directly with the Third Party Workers’ Compensation Administrator (TPA) or State Workers’ Compensation Agency (if applicable) to ensure timely processing of workers' compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate investigation; ensure that the claim is in compliance with applicable state laws and regulations; and monitor entire claims life cycle with TPA/State. This position requires a motivated HR professional to support the team and business by fostering a working environment that promotes positive communication, empowerment, development, and support. As a key member of the HR team, you will create the same positive working relationships with our client groups.

How You’ll Help

• Work collaboratively with third party administrators (TPA’s) to ensure reasonable responses to concerns and accuracy in the application of the policy and challenge when required.
• Works with Managers and Employees to initiate workers’ compensation claims with TPA.
• Facilitates State-owned Workers’ Compensation cases as needed in monopolistic states (North Dakota, Ohio, Washington, and Wyoming).
• Liaises with TPA/State Case Agents, and Human Resources Partners to review Workers’ Compensation cases and accommodations.
• Evaluates accident reports, department investigation results and other documentation. Compile facts and data regarding accident reports and filed cases to support reporting to TPA/state.
• Provides information and notices of return to work in accordance with local, state and federal regulations and the Workers' Compensation Act.
• Liaises with TPA/State to coordinate return-to-work programs and activities and ensures accommodations are met when applicable.
• Oversee and administer leaves requests and short-term disability claims in conjunction with TPA
• Maintains knowledge of all applicable leave and accommodation laws including the FMLA, ADA and state and local laws
• Strong analytical skills with the ability to collect, organize and analyze information with attention to detail and accuracy.
• Attends trainings and seminars, conducts research and maintains liaison relationship with TPA/State Agencies to stay in compliance with changing laws and trends.
• Other duties and projects as assigned.

Your Skills & Experience

• Post-secondary education, preferably in human resources, or a combination of education and experience. Medical course work preferred.
• Training in various federal and state Workers’ Compensation compliance and regulatory laws
• Training in DOT/OSHA compliance preferred
• Registered Nurse (RN) designation or nursing background considered a strong asset.
• Requires 3+ years of experience in medical claims analysis or a related field.
• Working knowledge of the Workers' Compensation Act and other applicable state/federal statutes and regulations
• Working knowledge of medical terminology, body systems and/or impairments and their disabling effects
• Working knowledge of office procedures and files
• Ability to obtain facts that ensure that claims information is complete and accurate
• Ability to balance/prioritize cases and liaise with TPA as required
• Ability to evaluate time-loss claims information to estimate impact
• Good judgment in interpreting medical facts presented by a physician and applying these facts in determining an individual's capacity to engage in gainful occupation within the business
• Effective communication skills
• Ability to maintain satisfactory working relationships with co-workers, the general public and other agency personnel
• Strong interpersonal and communication skills (both verbal and written)
• Completes work with a high attention to detail and maintain a high level of confidentiality
• Ability to multi-task in a fast-paced environment
• Strong analytical skills with the ability to collect, organize and analyze information with attention to detail and accuracy.
• English is required, other languages an asset
• Independent contributor, able to work with little supervision. No direct reports.

Travel/Mobility

• Limited travel may be required.

Environment

• Busy office environment with extensive computer work and handling of documentation
• May be required to visit other locations, including offices, terminals, maintenance shops, etc.

Physicality

• Prolonged periods sitting at a desk and working on a computer

Work Schedule

• Normally 40 hours per week, Monday to Friday; may be required to work different or additional hours from time to time

Safety

• Must follow all company requirements to promote a safe work environment. Perform all work safely in a fast-paced work environment. Required PPE must be worn at all times.

If you’re chosen for the role, you’ll be asked to provide reference and criminal background checks before employment. You’ll only be contacted if you’re selected for an interview.

About Day & Ross

From a single truckload of potatoes in the 1950s to a fleet of thousands, Day & Ross has grown to become one of the largest transportation and logistics providers in North America. With over 7,500 team members on and off the road in the US and Canada, we offer a diversified portfolio of freight and delivery solutions, including LTL, Truckload, Residential, Dedicated Fleet Solutions, and Logistics.

We believe our people are our greatest strength. For over a decade, we’ve been recognized as one of Canada’s Best Managed Companies. We’ve also been named a Top Company for Women to Work for in Transportation since 2018. Our recognition reflects the family values we share with our parent company, McCain Foods Limited.

As a federally regulated employer, Day & Ross fully supports the principles of employment equity and encourages all qualified members of the designated groups to apply. Day & Ross is committed to ensuring equal access and participation for people with disabilities and meeting their needs in a timely manner. We will do so by removing and preventing barriers to accessibility and by meeting our accessibility requirements under Accessible Canada Regulations and in alignment with our business practices, capabilities, and values.