Workers' Compensation Claims Specialist

Job Description

Job Description

Salary:

The Onin Group is a privately held, national, staffing group comprised of Onin Staffing, Focus IT, Excelsior Staffing, A3 Solutions, and Momentum Capital Funding. We are among the top two percent of domestic staffing companies in sales volume and feature the most sophisticated staffing industry technology and hiring practices available today.

The Workers' Compensation Claims Specialist investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor-intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.

• Coordinates special projects and provides guidance to others.
• Determines compensability under workers' compensation by a thorough investigation of the claim.
• Determines the causalrelationship between the reported injury and the incident to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Documents specifics of claims.
• Closes files following the resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses.
• Manages outside vendors to ensure cost containment efforts.
• Establishes and maintains effective working relationships with all internal and external customers.
• Stays abreast of changes in workers' compensation statutes, case law.
• Exercises independent judgment to settle cases prior to mediation or litigation.
• Conducts audits of claim files.

Job Requirements

Bachelor's degree in a related field. A relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy is required. Certification or progress toward certification is highly preferred and encouraged.

Five years experience in a workers' compensation claims environment which provides the necessary skills, knowledge, and abilities, such as experience in reviewing, investigating and closing complex workers' compensation claims. Experience handling claims in multiple jurisdictions preferred.

• Ability and proficiency in the use of computers and company standard software specific to the position.
• Excellent Microsoft Excel knowledge.
• Knowledge of medical and legal terminology related to the work.
• Knowledge of workers' compensation laws and regulations, including jurisdictional laws.
• Effective oral and written communication skills.
• Effective customer service skills.
• Ability to manage multiple priorities and meet established deadlines.
• Attention to detail and analytical skills is a must.
• Ability to work independently as well as within a team.
• Ability to make independent decisions.
• Ability to solve complex problems.
• Ability to train others.
• Must be able to work in a fast-paced, high volume atmosphere.