CareOne

  • Workers Compensation Claims Coordinator

    Job Locations US-NJ-Fort Lee
    Requisition ID
    2018-6027
    Position Category
    Human Resources
    Position Type
    Full-Time (37.5+)
  • Overview

    Position Description: This position requires extensive day-to-day contact with injured employees, medical providers, supervisors and insurance adjusters. The primary objective is to participate in and manage every significant medical event related to an employee’s workers’ compensation injury.

     

    • Act as a liaison between the injured employee’s physician, insurance company, management and employee to gain a timely return to work release.
    • Educate the injured employees on the worker’s compensation process.
    • Communicate with the injured employees about status of their claim.

    Responsibilities

    Position Goals and Objectives: The success of this position will be measured by the following:

    • Reduced attorney involvement.
    • Increased Closure rate of WC Claims.
    • Year-to-year reduction in overall Incurred Loss Value of WC Claims.
    • Populate a database with appropriate claim information accurately.
    • Assist the claims adjuster with obtaining additional information for the service and handling of claim.
    • Contact treating physician to obtain work status and information on employee’s condition.
      • Act in the capacity of an Workers’ Compensation Claims Coordinator to Injured co-employees:
        • Confirm basic information provided on the First Report of Injury.
        • For potential lost time claims, make contact with the injured employee within 24 hours of injury.
        • Explain the role of the Claims Coordinator in the Injured Worker’s claim and the recovery process. Emphasize Return to Work.
        • If possible, direct employee to designated medical provider.
        • Set target date for action items.
        • Diary files for a minimum of weekly contact with the injured employee.
        • Stay in constant contact with the injured employees through phone, fax, email, get-well-cards, casual notes, etc.
        • Work with Claims Adjuster and the Work Site Employer to devise strategies for Claim Closure or Return to Work Options.
        • Maintain contact with the medical provider on a regular basis. Push for medical restrictions and return to work opportunities for the injured employee.
        • Provide regular updates on the status of the injured worker to upper management.
        • Maintain and manage an “access type” data and claims management software system.Critical Personality Traits:

     

    • Strong client advocacy orientation.
    • Does not get discouraged easily.
    • Detail oriented.
    • Strong organizational skills.
    • Strong communication skills.
    • Sense of urgency.
    • Ability to handle many tasks, simultaneously.
    • Good listener.
    • Self Starter.
    • Must enjoy the challenges of helping people.
    • Thinks outside the box.

    Qualifications

    • Some college or medical training preferred but not required.
    • Bi-lingual- Spanish/English strongly preferred.
    • Excellent phone/communication skills. Must be able to converse comfortably with all levels, doctors, nurses, employers, adjustors and most importantly, the injured worker.
    • Must be able to work in a fast pace, multitasking environment.
    • High energy level required
    • Excellent organizational skills required.
    • Good computer/data entry skill.
    • Good problem solving skills.
    • Self Starter and “self finisher.”

     

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