Workers' Compensation Claims Specialist

MV Transportation; Dallas (TX); Remote; USD 60,000 - 80,000; Full time

Job summary

MV Transportation is seeking a Workers' Compensation Specialist responsible for managing claims and ensuring regulatory compliance. The role includes investigating claims, coordinating return-to-work processes, and ensuring effective communication with stakeholders. Ideal candidates will have relevant degrees and a strong background in claims management.

Qualifications

• Bachelor's degree or equivalent work experience required.
• 3-5 years in workers' compensation claims management.
• Strong knowledge of state regulations and laws.

Responsibilities

• Manage and oversee workers' compensation claims.
• Investigate claims and establish resolution action plans.
• Ensure compliance with regulatory and company policies.

Skills

Communication

Interpersonal skills

Analytical skills

Problem-solving skills

Education

Bachelor's degree in a related field

Tools

Claims management software (Riskonnect)

Job description

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The Workers' Compensation Specialist is responsible for managing and overseeing workers' compensation claims and ensuring compliance with state regulations. This role involves investigating and evaluating claims, coordinating early return to work, and establishing action plans to resolve claims efficiently.

• Investigate and evaluate both time loss and medical-only claims, coordinate early return to work, and establish action plans that lead to the resolution of claims.
• Communicate with TPA, medical providers, attorneys, location management, and injured workers.
• Comply with rules and regulations of the state.
• Document and communicate all claim activity timely and effectively in a manner that supports the outcome of the claim file.
• Follow direction and adhere to company best practices.

Position is remote.

Responsibilities:

• Timely communication with the Divisions to ensure an effective return to work process is executed to eliminate lost time and/or restricted duty cases.
• Coordinate effective communication with the injured employee on return to work expectations and responsibilities.
• Confirm and evaluate coverage and liability of varying complexity medical and indemnity claims.
• Secure and analyze necessary information and documentation in the investigation of claims.
• Coordinate support provided by Division Safety, TPA adjusters, attorneys (internal and external), and Field (FCMs) and Telephonic Case Managers (TCMs).
• Manage the litigation process and facilitate settlements.
• Ensure that claims payments are issued in a timely and accurate manner by the TPA.
• Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
• Exercise proper judgment and decision-making to analyze the claims exposure, determine the proper course of action, and appropriately settle the claim.
• Clearly communicate concise action plans and present plans for moving the case to conclusion.
• Handle a full caseload, with proven ability to handle cases of increased severity.
• Review TPA suggested claim strategies and courses of action.
• Manage claim recoveries via subrogation.
• Create and execute Cost Reduction strategies including reviews of defense rates, TCM/FCM rates, surveillance companies, etc.
• Ensure data accuracy around OSHA recordkeeping and compliance.

Talent Requirements:

• Bachelor's degree in a related field or equivalent work experience.
• Minimum of three (3) to five (5) years of experience in workers' compensation claims management.
• Strong knowledge of state workers' compensation laws and regulations.
• Excellent communication and interpersonal skills.
• Ability to handle multiple tasks and prioritize effectively.
• Strong analytical and problem-solving skills.
• Proficiency in using claims management software (Riskonnect) and other relevant tools.

MV Transportation is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin or ancestry, sex, physical or mental disability, veteran or military status, genetic information or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.

Where permissible under applicable state and local law, applicants may be subject to a pre-employment drug test and background check after receiving a conditional offer of employment.