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Benefits Specialist in Knoxville, TN at TeamHealth

Date Posted: 3/12/2019

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

Under supervision, coordinates and administers the workers compensation program. Processes and files all workers compensation claims, ensuring compliance with relevant policies, procedures, and legislation. Maintains record of work-related illnesses and injuries as required to meet OSHA standards. Provides exemplary customer service and assistance to associates, executives and HR business partners.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Files claims with insurance carrier for work-related accidents; ensures completeness and clarity of claims data; analyzes data, as needed, to ensure compliance with policy and regulatory requirements.
  • Ensures that all legal and procedural requirements are met for the timely filing of claims, and provides additional documentation as requested by the carrier.
  • Keeps in regular communication with claimants to lower risk of them seeking legal representation for lack of information or contact and helps in getting them returned to work as quickly as possible.
  • Acts as a liaison to facilitate communication between the carrier, management, and the claimant.
  • Serves as a resource for HR and managers on the interpretation and application of worker's compensation policies, legislation, regulations, and processes, as well as on loss control procedures and related regulations; designs and implements training and orientation programs to disseminate this information to TeamHealth managers.
  • Coordinates and participates in annual (or more frequent) large claim reviews.
  • Works with accounting department to ensure appropriate reserves are set aside for any open or pending claims.
  • Assembles appropriate medical information and facts regarding claims for cases pending litigation; works with various legal agencies assigned by the WC carrier on mediation and formal hearings.
  • Communicates and interacts with insurance representatives, support agencies, managers etc. to monitor and assess the progress of rehabilitation efforts, and to facilitate either return to work or, depending upon medical status of the claimant, placement into appropriate alternative positions, ensuring compliance with all appropriate regulations and guidelines.
  • Prepares all necessary forms, records and documentation, to include statistical analyses and reports, for all claims assigned, as required by various regulatory agencies.
  • Coordinates and/or conducts telephonic and on-site assessments with employees and Safety Representatives to address safety and ergonomic issues.
  • Makes recommendations for reducing the frequency and severity of losses with the assistance of our WC carrier.
  • Researches law changes to remain up to date and in compliance with all workers’ compensation laws, OSHA, ADA, and other applicable laws. Identifies improvement opportunities in existing safety, ergonomic, and workers’ compensation concepts to ensure functions are effective and efficient.
  • Completes other duties related to the Benefits and/or special projects, tasks as assigned including assisting in Open Enrollment activities.

TEAMWORK:

  • Participates in an integrated work team as a responsible team member.
  • Assists in the facilitation of the team process at TeamHealth by serving as an active member of the team. This includes attending all team related meetings; participating in developing and implementing center-wide and team goals; participating in problem-solving and decision making; supporting corporate and center management decisions; being flexible and adaptable to change; establishing trust and respect for other team members; placing team needs first; and by completing all necessary training.
  • Follows the norms and guidelines established by the team for communication, production, efficiency, conflict resolution, decision-making, problem-solving, and interpersonal relations.

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Bachelor’s degree or equivalent education/experience;
  • Two (2) - four (4) years previous benefits and Workers Comp experience;
  • Excellent computer skills (word-processing, spreadsheet); Lawson system experience preferred;
  • Excellent interpersonal skills as well as judgment and decision-making skills;
  • Excellent organizational skills with strong attention to detail
  • Excellent communication skills (verbal/written);
  • Excellent analytical skills;
  • Ability to function as part of a team yet work with minimal direction/supervision;
  • Ability to work in a fast-paced, dynamic work environment.

SUPERVISORY RESPONSIBILITIES:

  • None

PHYSICAL / ENVIRONMENTAL DEMANDS: 

  • Job performed in a well-lighted, modern office setting;
  • Occasional lifting/carrying (20 pounds or less);
  • Occasional standing/bending/stooping/reaching;
  • Prolonged sitting; and
  • Prolonged work in a computer/PC.  

DISCLAIMER:

  • This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
  • Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.