Workers' Comp Claims Specialist: Return-to-Work Advocate

State of Ohio; North Canton (OH); On-site; USD 76,114,000 - 98,876,000; Full time

Job summary

The Canton Workers' Compensation claims office of the Ohio Bureau of Workers' Compensation is seeking a full-time Canton WC Claims Specialist to manage a caseload of claims and coordinate with internal partners to set return-to-work expectations.

Responsibilities include investigation, determining eligibility, handling multiple compensation types, and responding to inquiries while adhering to state policies and procedures. On-site work with OCSEA union representation is standard.

Qualifications

• 36 mos. exp. in evaluating medical or public assistance benefits to determine eligibility or deny benefits.
• Undergraduate coursework in business, humanities, social & behavioral science, education or related field.
• 12 mos. exp. in evaluating medical or public assistance benefits or related duties.
• 24 mos. exp. as Workers' Compensation Claims Assistant or related roles.
• Combination of 36 mos. exp. in benefit evaluation and related positions or equivalent.

Responsibilities

• Manages a caseload of Workers' Compensation claims and coordinates with internal and external stakeholders to set return-to-work expectations.
• Performs initial/subsequent claims investigation and determination within timeframes; contacts parties and gathers information.
• Processes compensation types and addresses requests via due process notification, investigations, and referrals.
• 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

Tools

Microsoft Office

Job description

The Canton Workers' Compensation claims office of the Ohio Bureau of Workers' Compensation is seeking a full-time Canton WC Claims Specialist to manage a caseload of claims and coordinate with internal partners to set return-to-work expectations.

Responsibilities include investigation, determining eligibility, handling multiple compensation types, and responding to inquiries while adhering to state policies and procedures. On-site work with OCSEA union representation is standard.