Workers Compensation Specialist

Under general direction, the worker's compensation specialist ensures timely processing of workers' compensation claims' evaluates accident reports to determine accuracy and completeness and to ensure adequate investigation; ensures that the state complies with applicable laws and regulations; provides training and guidance to claims coordinators in all departments; oversee and manage all Risk Management documentation and maintains an organized virtual and manual filing system. Duties and Responsibilities Evaluate accident reports, ensuring the timely processing of medical bills and temporary total disability benefits, review medical reports, witness statements, department investigation results, and other documentation. Compiles facts and data regarding accident reports and filed cases. Maintains subrogation records and files for those incidents involving third parties; sends subrogation letters to third parties to obtain reimbursement of monies spent by the city for medical treatment, time loss, and awards and settlements paid; submits amounts paid for medical treatment and/or temporary total disability benefits to the State Attorney's Office to seek reimbursement in cases where criminal charges have been filed. Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued; authorizes payment of medical bills and temporary total disability benefits upon receipt of proper documentation. Advises and/or assists departments in investigating accident reports, including interviewing of witnesses and procurement of relevant documentation. Reviews accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident; advises departments of trends in injuries and proper safety procedures that may result in a reduction of injuries; provides the department with information that will aid in reducing accidents and improving safety. Trains safety coordinators in the proper procedures and forms to be utilized in workers' compensation matters and the preparation of accident reports, notices of absence, and notices of return to work following city regulations and the Workers' Compensation Act. Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills; prepares summaries of medical reports; ensures that state claim forms are properly prepared and filed. Attends seminars, conducts research, and maintains liaison with individuals in the medical community and healthcare fields to keep abreast of current medical procedures and medications. Track claims from filing through follow-up with employee supervisors/claim coordinators. Notifies safety managers of employee incidents and claims. Manages incident case files and ensures employees' confidential access to information. Coordinates with payroll personnel for compensation benefit plans. Fill out pre-qualification paperwork. …