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Workers Compensation Specialist

Company: Kellermeyer Bergensons Services, LLC
Location: Oceanside
Posted on: March 15, 2020

Job Description:

JOB DESCRIPTION IDENTIFICATION Job Title: Workers Compensation Department: Human Resources FLSA Classification: Non-Exempt Status: Full-time OVERVIEW OF JOB The Workers Compensation Analyst ensures timely processing of workers' compensation claims, evaluates accident reports to determine accuracy and completeness and ensures that adequate investigations were conducted. This position ensures that KBS is in compliance with applicable laws and regulations and provides training and guidance to field managers in multiple states. Works closely with field managers to improve workers' compensation results, including loss prevention and claims management. This position provides high-level analysis regarding risk management based on claims data.
ESSENTIAL JOB FUNCTIONS

  • Approves claim settlements within authority level
  • Responds to requests from carrier to increase reserves, conduct surveillance and assign Nurse Case Management to improve outcome
  • Review safety and loss prevention programs and provide assistance in implementing changes and updates
  • Assist in creating and implementing safety training for the field
  • Evaluate processes to assess risk and adherence to company policies and safety regulations
  • Conduct safety observations and evaluate risks as jobs are performed
  • Implement safety policies and procedures in compliance with local, state, and federal rules and regulations including Occupational Safety and Health Administration (OSHA) and Department of Transportation (DOT)
  • Executes and maintains OSHA-related regulatory programs and documentation
  • Analyze, trend, and reduce the occurrence and cost of work related injury claims
  • Ensure workers' compensation claims are responded to timely and accurately
  • Review accident investigations, injuries, and OSHA logs
  • Review open claims with field managers and carrier
  • Attend quarterly claims reviews with carrier
  • Facilitate communication between legal team, manager, carrier and/or state agency, as needed
  • Effectively handle information and reports while maintaining the strictest confidentiality
  • Communicate actively with field, HR, and Legal to facilitate the timely and accurate processing and closures of workers' compensation claims
  • Manage regular preparation of relevant management reports, including weekly, monthly, quarterly and year-end reports
  • Analyze and identify trends related to claims activity over a period of time and help create tactics to mitigate liability
  • Respond to worker's compensation questions from KBS leadership, former employees, insurance carrier, claims administration vendors, representatives and government agencies in a timely manner
  • Properly document and maintain worker's compensation claims activities, documents, interactions and related materials in designated applications
  • Comply with federal, state and local legal requirements by being knowledgeable of existing and new legislation, ensuring adherence to requirements and advising management on needed actions
  • Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, or participating in professional societies.
  • Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others
  • Performs other related duties as required and assigned. QUALIFICATIONS
    • Strong investigations skills highly desired!
    • Multi state experience a plus!
    • Understands and follows workers' compensation regulations
    • Able to manage and participate in cross-functional relationships
    • Demonstrates orientation to detail and organization but able to grasp big-picture concepts
    • Has excellent telephone and customer service skills
    • Ability to communicate with all levels of management and employees
    • Ability to learn quickly and understand priorities
    • Demonstrates superior time management skills, including sensitivity to urgent matters
    • Ability to anticipate potential issues in advance to mitigate disruptions
    • Has strong planning and organizational skills
    • Appreciates the importance of maintaining confidentiality of employee, customer and company information
    • Demonstrates honesty and integrity at all times
    • Ability to function independently, as well as part of a team
    • Ability to follow appropriate safety guidelines
    • Demonstrates ability to be flexible, prioritize tasks and responsibilities and complete duties and projects within allotted time
    • Able to respond to change productively and to handle additional tasks and projects as assigned
    • Must be bilingual in English and Spanish EXPERIENCE REQUIRED
      • 3-5 years' experience managing workers' compensation claims
      • Minimum of 3-5 years' loss prevention and safety experience with a multi-site organization
      • Knowledge of OSHA General Industry standards, state safety statues and local municipal regulations
      • OSHA certification preferred, but not required; may complete within first year of employment EDUCATION
        • Bachelor's degree in business or risk management-related field preferred LANGUAGE SKILLS
          • Must be bilingual in English and Spanish
          • Must be able to read and interpret documents, such as letters, email communication, safety rules, operating instructions and procedure manuals in oral, written or diagram form
          • Must be able to write detailed and summary reports
          • Must be able to participate in developing policies, procedures, forms and materials MATHEMATICAL SKILLS
            • Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
            • Must be able to apply mathematical concepts to practical solutions
            • Must be able to analyze statistical reports REASONING ABILITY
              • Ability to apply common sense understanding to carry out instructions
              • Ability to deal with standardized situations with only occasional or no variable
              • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists COMPUTER SKILLS
                • To perform this job successfully, an individual should have knowledge of Microsoft Office programs to include, but not limited to Word, Excel, PowerPoint and Outlook PHYSICAL DEMANDS
                  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
                  • While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand, walk, stoop, kneel, crouch, or crawl and taste or smell.
                  • The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
                  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. WORK ENVIRONMENT
                    • Office environment has minimum hazards. May include varying temperatures. Noise level is usually moderate.

Keywords: Kellermeyer Bergensons Services, LLC, Oceanside , Workers Compensation Specialist, Other , Oceanside, California

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