The Work Comp Admin position provides claim support to the WC Claim staff in all key phases of the process, consistent with Best Practices. Utilize specific workers compensation insurance knowledge, information gathering, tracking, reporting, and inquiry resolution for the PEO workers’ compensation underwriting team, work comp vendor partners, and field service staff. Meets or exceeds expectations for customer service including administrative support and renewal activities.
Duties:
- Communicate with new clients Risk Management (RM) policy and Procedures.
- Send and review the Risk Management claim kit, claim reporting requirements, return to work, chain of custody forms and physician panels.
- Files new claims with the appropriate carrier. Copy RM team on all communications.
- Send claim adjuster copies of all claim documents.
- Follow up on all drug test results and communicate results to the RM team, claim adjuster and client.
- Setup and enter new workers’ compensation claims into claims folders in the CHR management system and Prism system.
- Files all ongoing claims correspondence in the claims folder.
- Communicates effectively with the RM team, client and the workers’ compensation adjuster regarding follow-up medical appointments, drug test results, and medical treatment records.
- Calculates wage statements.
- Issues certificates of workers’ compensation insurance upon client request, in a timely manner.
- Communicate with the Accounting Department to bill client for certificate of insurance.
- Support departmental projects following up on pending details and coordinating work with other team members.
- Analyse problems and determine effective resolutions or develop recommendations for improvements.
- Communicate with the state, carriers, and RM team about new and terminated clients.
- Draft, format, produce, edit, and proofread a variety of documents.
- Update and maintain client contact list and claim fee spreadsheet.
- Prepare and send OSHA log data to the clients.
- Communicate to customers how risk/safety issues impact business.
- Creates and presents worker’s compensation presentations and training.
- Provides OSHA and government regulation updates to client companies, including education on any changes.
- Performs initial risk/safety orientations, informs clients of risk services provided and discusses client PEO responsibilities.
- Documents all client interactions in accordance with departmental guidelines.
- Research various topics and stay abreast of changing legislation and regulations.
- Serves as a resource to the Sales Team and Human Resources and promotes the company to potential clients.
- Prepare reports for Monopolistic state Worker’s Compensation policies.
- Prepare and submit reports for workers’ compensation carriers.
Education and Experience:
- H.S. Diploma – Preferred
- Associate Degree – Preferred
- Proficient in Excel – Required
- 1 year of experience in administrative skills experience in a high paced business environment.
- 1 year of experience in Workers Compensation and PEO experience.
- 1 year experience with PRISM – preferred
Skills and Abilities:
- Computer proficiency and technical aptitude with the ability to use Microsoft Suite, including Excel, Word, and Outlook
- Proven ability to work effectively in a team environment with associates.
- Effective planning and priority setting.
- Ability to manage several complex projects simultaneously while working under pressure to meet deadlines.
- Excellent analytical thinking, problem-solving, and decision-making skills.
- Excellent communication and organizational skills.
Job Type: Full-time
Pay: $18.00 – $21.00 per hour