Workers Compensation Adjuster 1

at  Franciscan Missionaries of Our Lady Health System

The Workers Comp Adjuster 1 coordinates the administration of the workers’ compensation program. Responsibilities include claims monitoring and administration, report generation, and communication with employees, managers, insurance carriers, medical personnel and lawyers. Familiar with standard concepts, practices, and procedures within a particular field. Relies on education and training to complete responsibilities. Initially requires instruction and guidance to accomplish job which should develop into working under general supervision.

• Claims Management
• Directs & manages investigative activities related to w/c claims. Maintains contact with injured employee and physicians in an effort to assess continued necessity of treatment related to the claim
• Ensures that all activities are accurately and timely posted in the databases
• Manages cases to ensure good, timely care in a cost-effective manner.
• Calculates applicable payroll, sets reserves on claims, and processes payments in timely manner.
• Supervision
• Provides supervision to all w/c claimants who are away from work and on modified duty assignments
• Works with hospital managers to provide suitable modified duty assignments for claimants
• Works with hospital managers and HR to counsel employees who do not follow hospital procedures
• Litigation and Reporting
• Represents hospital in mediation and trials
• Reviews cases for qualification under Second Injury Fund
• Prepares & maintains accurate OSHA logs, LA report of annual w/c costs, and other reports as required
• Prepares reports of incidents/claims for distribution to hospital management
• Bachelor’s degree or equivalent years in healthcare of legal environment
• Excellent oral/written communication skills, ability to problem solve and set priorities in a face paced environment

• Claims Management
• Directs & manages investigative activities related to w/c claims. Maintains contact with injured employee and physicians in an effort to assess continued necessity of treatment related to the claim
• Ensures that all activities are accurately and timely posted in the databases
• Manages cases to ensure good, timely care in a cost-effective manner.
• Calculates applicable payroll, sets reserves on claims, and processes payments in timely manner.
• Supervision
• Provides supervision to all w/c claimants who are away from work and on modified duty assignments
• Works with hospital managers to provide suitable modified duty assignments for claimants
• Works with hospital managers and HR to counsel employees who do not follow hospital procedures
• Litigation and Reporting
• Represents hospital in mediation and trials
• Reviews cases for qualification under Second Injury Fund
• Prepares & maintains accurate OSHA logs, LA report of annual w/c costs, and other reports as required
• Prepares reports of incidents/claims for distribution to hospital management
• Bachelor’s degree or equivalent years in healthcare of legal environment
• Excellent oral/written communication skills, ability to problem solve and set priorities in a face paced environmen