Workers Compensation Technician

at  Colorado State University

DESCRIPTION OF WORK UNIT

The Office of Risk Management & Insurance (RMI) and the Workers’ Compensation Division, works closely with risk partners across the university campus and community. The RMI team is comprised of experts in the field of insurance, claims management, risk management, loss prevention and ergonomics.

POSITION SUMMARY

This position assists the Workers’ Compensation Manager in all aspects in running an efficient Workers’ Compensation program.

• The position is responsible for daily processing of injury claims, providing and receiving information and ensuring claims information is accurately recorded in the database and distributed to pertinent parties.
• This position has regular and ongoing communication with the WC (Workers Compensation) Program Manager, and other pertinent parties to a claim, providing support to ensure the smooth process of each claim from intake through case closure.
• This position uses specialized knowledge of Workers’ Compensation statutes and rules, and implements Workers Compensation processes and operations to accomplish the program’s goals and needed work product.
• This position regularly deals with campus department personnel, CSU employees, medical providers, adjusters, to provide and obtain accurate information.
• This position requires a conscious awareness and ability to navigate through various business practices and protocols.
• This position requires the ability to deal effectively with diverse populations and professions and must handle encounters professionally while staying within the scope of confidentiality and job role.

This position is eligible for a hybrid work schedule with the requirement of 2 days in-office/on-campus.

MINIMUM QUALIFICATIONS

To be considered for this position, candidates must demonstrate in the application materials:

• Three (3) years of relevant experience and/or education in human resources, medical administration, vocational rehabilitation, workers’ compensation claims management, risk management insurance adjusting, or a closely related field. (1 year of experience = 30 credit hours) *Certificates, unofficial or official transcripts must be attached.

PREFERRED QUALIFICATIONS

The highly desired candidate will possess the following knowledge, skills, abilities, personal characteristics, and experience directly related and critical to this position:

• Demonstrated Intermediate to Advanced computer skills: MS Word, MS Excel, MS Teams, and MS PowerPoint.
• 1 year of experience in working in Workers Compensation.
• Experience in using the Origami Risk Data System
• Experience working with Computer Information Systems, specifically related claims and business software.
• Work experience as workers compensation adjuster/benefits provider or medical assistant in an Occupational Health Clinic.
• Bilingual (Spanish and English.)

Essential Job Duties

TO SUCCESSFULLY ACCOMPLISH JOB REQUIREMENTS THIS POSITION WILL:

• Receive, review, complete and submit CSU Workers Compensation claims.
• Claims are received through various methods: via website, email, telephone, or paper copy.
• Accurately enter the information into CSU Risk Management Information System (RMIS), contact the employee, supervisor, or Designated Departmental Person (DDP) to gather information that is not complete or clear in the initial reporting of the claim.
• Process claims through our outside Third-Party Administrator or Insurance carrier.
• Direct injured employees in seeking medical care from an Authorized Treating Physician.
• Use their specialized knowledge to decide whether other resources are needed to:
• investigate the injury or
• determining compensability,
• preventing further injuries in the future.
• Collaborate and/or refer to the WC Manager when various flags are present.
• Make referrals to appropriate Environment Health Services/Risk Management resources as directed.
• Send out initial claim information to pertinent parties.
• Follow up to obtain needed signed information and record information into the database system.
• Design, change and implement processes to get needed information to pertinent parties,
• Follow up with employees and departments for the collection of information:
• Authorized Treating Physician, and employee guide acknowledgment and signatures.
• Completion of Return-to-Work forms by department.
• Completion and accuracy of missed time reports.
• Tracking of Injury leaves and Temporary Modified Duty.
• Obtain medical records, provider billing information, assist in getting bills processed, pharmacy prescriptions, mileage and other financial issues addressed, as appropriate.
• Reviewing medical information, emails, payments received and other correspondence and ensure that the information is accurate and filed in the correct claim file.
• When information is incorrect, this position will request changes and/or bring inaccuracies to the attention of the WC manager to be addressed.
• Alert the Workers’ Compensation Manager regarding any items that warrant her review and action.
• Sends out claim information, including medical status to CSU parties and MUST understand and ensure that only essential information is provided and only to pertinent parties. Confidentiality is of utmost importance.
• This position must effectively explain the process to CSU stakeholders.
• This position works closely with all departments at CSU and is responsible for setting up Departmental Designated Persons (DDPs) in each department.
• Identify and confirm appropriate contacts and provide DDP with information regarding the WC process, their responsibilities for their employees, department, and reporting requirements.Maintain up to date DDP information within the location section in the Origami system.

Please refer the Job description for details