Workers' Compensation Specialist

Location
Washington D.C
Posted
Jan 04, 2022
Closes
Jan 15, 2022
Ref
211135
Function
Other
Hours
Full Time
Minimum Qualifications:

Education
  • Bachelor's degree from an accredited college or university

Experience
  • A minimum of five (5) years' experience specific to workers' compensation claims adjusting

Certification/Licensure
  • N/A

Preferred
  • WC Claims, Broker and/or Underwriting experience preferred
  • Associate in Claims (AIC)

ESSENTIAL FUNCTIONS
  • Manages Worker's Compensation (WC) "Return to Duty" process, coordinating with operations, payroll, Third Party Administration (TPA), and other departments. Assists Manager, Workers' Compensation in oversite of the WC TPA to ensure compliance with Workers' Compensation Claims Manual (WCCM) and WC Policy Instruction (P/I).
  • Develops and conducts regular training as directed by Manager, Workers Compensation with respects to WCCM, (including but not limited to WC claim reporting procedures, WC P/I, new WC rules/laws and WC fraud recognition and prevention) to ensure and improve effectiveness and efficiency of WC claims programs.
  • Liaison for litigated WC claim activity between WMATA litigators (Counsel) and WMATA TPA to improve coordination of claim activities through ongoing communications and timely exchange of information.
  • Provides a channel into WMATA internal departments (including but not limited to OHAW, Operations, HR, Payroll) to assist TPA claim adjusters in accessing internal information that is necessary to adjust claims.
  • Assist with internal processing of invoices, recovery of checks/drafts, procurement activities, obtaining wage information, PARP requests, and other activities associated with the management of WMATA WC programs as directed by Manager, Workers Compensation.
  • Analyzes WC claims for unsafe conditions and/or means to improve safety in WMATA work environment.
  • Assists with the management of data in WMATA's Risk Management Information Systems RMIS system (Origami) and TPA claims system(s) to ensure accuracy of data and assist in the management/coordination of data between the two systems, WMATA RMIS and TPA claims systems.
  • Represent WMATA as an expert witness in litigated claims.
  • Assist Manager, Workers' Compensation in conducting audit of WC TPA to ensure compliance with WCCM, WC P/I and TPA contract. Analyze WC claims for unsafe conditions and/or means to improve safety in WMATA work environment.
  • Works with WMATA Workforce Availability (Light Duty) to maximize participation of eligible employees in WMATA's Light Duty program.
  • Act as resource for answering questions about Workers' Compensation and WMATA's WC claim programs.

Medical Group:

Satisfactorily complete the medical examination for this position, if required. The incumbent must be able to perform the essential functions of this position either with or without reasonable accommodations.

Job Summary/Duties:

The Workers' Compensation Specialist is responsible for assisting in the management and administration of WMATA's Workers' Compensation claims programs.

Evaluation Criteria

Consideration will be given to applicants whose resumes demonstrate the required education and experience. Applicants should include all relevant education and work experience.

Evaluation criteria may include one or more of the following:
  • Skills and/or behavioral assessment
  • Personal interview
  • Verification of education and experience (including certifications and licenses)
  • Criminal Background Check (a criminal conviction is not an automatic bar to employment)
  • Medical examination including a drug and alcohol screening (for safety sensitive positions)
  • Review of a current motor vehicle report

Closing

WMATA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable federal law.

This posting is an announcement of a vacant position under recruitment. It is not intended to replace the official job description. Job descriptions are available upon confirmation of an interview.

Similar jobs