Overview:
The Senior Workers’ Compensation Program Supervisor is responsible for assisting in the administration of Workers’ Compensation claims. Responsibilities include review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential. The WCCA will work closely with TPA adjusters, defense counsel, HR and Operations/Field.

Responsibilities:

• Open, monitor, coordinate and follow up on Workers’ Compensation claims until closed using various internal and external Risk Systems.
• Setup and determine validity & compensability of claim within 24 hours by investigating, gathering information and collaborating with the operations team/Injury Coordinators.
• Identifies potential subrogation claims.
• Coordination of wage statements, subpoena’s, hearings, and investigations.
• Communicate claim status to internal team.
• Develop and manage well documented action plans with TPA adjuster, insurance carrier, attorneys & the field to effectively mitigate claim costs.
• Coordinate modified duty return to work with FCN, operations, HR and TPA adjuster
• Maintain general knowledge of legislation regarding Workers’ Compensation within your jurisdictions.
• Approve reserves & authorize increases within reserving authority limits, 50K
• Review, process and conclude both limited and high exposure claims valued up to 250K. Oversee litigation process and settlement with assistance from WC Manager.
• Maintain confidentiality of medical records.
• Create OSHA logs.
• Assist Manager in closing out long term claims.
• Run and distribute Monthly Loss Run Financial Reports.
• Assist Director and Manager in the Claims Department with requested tasks or special projects.
• Adhere to company guidelines & participate in claim reviews as scheduled.

Qualifications:

• High School Diploma
• Minimum 8 years of experience in the handling of Workers Compensation Medical Only and Lost Time Claims.
• Proven critical thinking skills that demonstrate analysis/judgement and sound decision making with focus on attention to details.
• Strong verbal, written communication skills and customer service
• Computer applications using MS Office, Excel and Word
• Demonstrate professionalism and mutual respect working with employees and external vendors.

EQUAL OPPORTUNITY EMPLOYER/PROTECTED VETERANS/INDIVIDUALS WITH DISABILITIES

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
LA County Applicants: The Company will consider qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local laws

• Open, monitor, coordinate and follow up on Workers’ Compensation claims until closed using various internal and external Risk Systems.
• Setup and determine validity & compensability of claim within 24 hours by investigating, gathering information and collaborating with the operations team/Injury Coordinators.
• Identifies potential subrogation claims.
• Coordination of wage statements, subpoena’s, hearings, and investigations.
• Communicate claim status to internal team.
• Develop and manage well documented action plans with TPA adjuster, insurance carrier, attorneys & the field to effectively mitigate claim costs.
• Coordinate modified duty return to work with FCN, operations, HR and TPA adjuster
• Maintain general knowledge of legislation regarding Workers’ Compensation within your jurisdictions.
• Approve reserves & authorize increases within reserving authority limits, 50K
• Review, process and conclude both limited and high exposure claims valued up to 250K. Oversee litigation process and settlement with assistance from WC Manager.
• Maintain confidentiality of medical records.
• Create OSHA logs.
• Assist Manager in closing out long term claims.
• Run and distribute Monthly Loss Run Financial Reports.
• Assist Director and Manager in the Claims Department with requested tasks or special projects.
• Adhere to company guidelines & participate in claim reviews as scheduled