YesCare Corp Worker's Compensation Manager in Brentwood, Tennessee
Experience & Requirements
The Workers Compensation Manager is the primary person to facilitate the administration of the workers' compensation program. The primary objectives are to manage the claims handling process through all phases by monitoring, processing and following through to resolution of claims and cases. The incumbent will also access and refine internal processes and procedures and bring process improvement recommendations to leadership.
Bachelor’s Degree in Business Administration or Healthcare preferred. Equivalent experience may be substituted in lieu of degree.
5-10 years’ directly related experience. Experience in healthcare field preferred.
Experience in providing client service in a professional business environment desired
Strong value of service to others with the ability to make decisions in compliance with department standards required
Ability to use independent judgment and make appropriate insurance claims adjustment decisions and determinations
Excellent oral and written communications skills. Organization and follow-up skills.
Ability to track the status of assigned claims to their successful and timely completion required
Ability to organize and prioritize a workload to meet deadlines required
Knowledge of data management systems and processes
Ability to work with all levels of business contacts to include: Physicians, injured workers, managers, team member, lawyers, claim adjusters, private investigators, medical managers.
Must be trustworthy and have the ability to handle highly confidential information with the utmost care and discretion required
Occasional travel required
No unusual physical requirements. Requires no heavy lifting, and nearly all work is performed in an office environment. Specific vision abilities required by this job include close vision and ability to adjustfocus. Frequently required to sit, use hands/fingers to handle or feel, and talk/hear.
Lead the employee communication process. May also initiate contact with injured employees to explain the Workers' Compensation process as it relates to the injured employee. Provides an overview of the insurance company, employee's physician, YesCare, and employees’ roles while the injured employee is covered by Workers' Compensation.
Accurately and completely document conversations and maintain an accurate electronic file of communication related to the injured employee's Workers' Compensation claim.
Facilitate the claim reporting process. Ensure claim information and injury reports are accurately and promptly submitted to the appropriate insurance carrier. Analyze data, as needed, to ensure compliance with policy and regulatory requirements.
Lead claims review process internally and with insurance carrier and outside counsel.
Provide authoritative advice and communicate with site leadership and injured employee (meeting specific criteria) to ensure work restrictions and information on injured employee's condition and treatment plan are in effect.
Act as a liaison between the injured employee's physician, insurance company, nurse case manager, management and employee to gain a timely return-to-work release.
Makes strategic recommendations for reducing the frequency and severity of losses through the use of a workers' compensation database and/or other claims data reports; designs and develops data bases, performs integrated data analyses, and prepares reports.
Maintain communication with the Employee Safety Department and insurance carrier.
Facilitate administrative support, ensuring needed information is gathered such as wage statements, work status updates, medical release/restriction documents are provided to insurance company, Workers’ Compensation Department and site leadership.
Provide and distribute meeting agendas, invites and materials for department sponsored meetings.
Establish and maintain safety policies and procedures. Establish and lead a company-wide safety committee.
Coordinate with human resources department on leave administration.
Provide leadership training on workers compensation and return to work program.
Coordinate and complete annual OSHA reporting. Ensure compliance with OSHA requirements.
Assist in completion of special projects and initiatives on an as needed basis.
Assist in completion of other duties as assigned.
About YesCare Health
By choosing a career with YesCare, you are choosing the opportunity to truly make a difference in the health, well-being, and future of the patients you serve. We take pride in being a pioneer provider of correctional healthcare. As a YesCare professional, you have access to the resources and support to enhance your skills, build a solid foundation to reach your career potential, and contribute to the care and well-being of an underserved population. There is no greater calling. Join YesCare today and be part of our legacy of innovation and clinical expertise.
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Job Locations US-TN-Brentwood
Position Type Regular Full-time
Shift / Schedule Weekday Day
Location ID 99400