Workers Compensation Specialist

Workers' Compensation Specialist

Pay Rate: $40,000 - $70,000 Depending on experience and location.

Position Summary

The Workers' Compensation Specialist is responsible for administering and coordinating all aspects of the company's workers' compensation program. This role ensures timely reporting and management of workplace injuries, facilitates communication among employees, medical providers, insurance carriers, and management, and supports return-to-work initiatives. The specialist works to minimize claim costs while ensuring compliance with federal, state, and company policies.

Key Responsibilities

Claims Administration

• Manage the full lifecycle of workers' compensation claims from initial injury reporting through claim closure.
• Ensure timely and accurate reporting of workplace injuries to insurance carriers, third-party administrators (TPAs), and regulatory agencies.
• Maintain detailed and confidential claim records and documentation.
• Monitor claim status and follow up regularly with insurance adjusters and medical providers.

Employee Support and Communication

• Serve as the primary point of contact for injured employees regarding workers' compensation claims.
• Educate employees and managers on workers' compensation processes, benefits, and responsibilities.
• Coordinate communication among employees, supervisors, healthcare providers, insurance carriers, and legal representatives.

Return-to-Work Coordination

• Manage and administer workers' compensation leave of absence, return-to-work and modified-duty programs.
• Review work restrictions and collaborate with management to identify appropriate accommodations.
• Track employee recovery progress and facilitate successful transitions back to work.

Compliance and Risk Management

• Ensure compliance with all applicable federal, state, and local workers' compensation laws and regulations.
• Monitor OSHA recordkeeping requirements and assist with injury reporting and documentation.
• Maintain workers' compensation policies and procedures.
• Support workplace safety initiatives aimed at reducing injuries and claims.

Reporting and Analysis

• Prepare and distribute workers' compensation reports, claim summaries, and trend analyses.
• Track key performance indicators, including claim frequency, severity, lost-time cases, and claim costs.
• Identify trends and recommend strategies to reduce workplace injuries and associated costs.
• Assist with annual workers' compensation audits and insurance renewals.

Vendor and Carrier Management

• Partner with insurance carriers, TPAs, medical providers, and legal counsel to ensure effective claim management.
• Participate in claim review meetings and provide recommendations for claim resolution.
• Review invoices and claim-related expenses for accuracy and compliance.

Education/Knowledge/Skills/Experience Desired

Education

• Preferred Bachelor's degree in Human Resources, Business Administration, Occupational Health, Risk Management, or a related field preferred.
• Equivalent combination of education and experience may be considered.

Experience

• 03 years of experience managing workers' compensation claims, leave administration, or risk management programs.
• Experience working with insurance carriers, TPAs, and return-to-work programs.
• Multi-state workers' compensation experience preferred.

Knowledge, Skills, and Abilities

• Strong knowledge of workers' compensation laws, regulations, and claim management practices.
• Understanding of OSHA reporting and workplace safety principles.
• Excellent communication, interpersonal, and conflict-resolution skills.
• Strong organizational and time-management abilities.
• Ability to manage multiple claims and priorities simultaneously.
• Proficiency with HRIS systems, claims management software, and Microsoft Office Suite (Excel, Word, PowerPoint).
• Ability to maintain confidentiality and exercise sound judgment.

Preferred Certifications

• Associate in Claims (AIC)
• Certified Workers' Compensation Professional (CWCP)
• Professional in Human Resources (PHR) or SHRM-CP
• Occupational Safety certifications are a plus

Physical Requirements

• Ability to sit and work at a computer for extended periods.
• Occasional travel to company locations, trials or claim review meetings as needed.

Key Performance Indicators (KPIs)

• Timely claim reporting and resolution.
• Reduction in lost-time incidents.
• Return-to-work program effectiveness.
• Workers' compensation claim cost management.
• Regulatory compliance and audit results.
• Employee satisfaction with claims administration process.