Workers' Compensation Specialist

Job Description

We offer a competitive salary for this role, with an expected range of $52,600 – $66,700/yr. The final offer will depend on your experience, skills, and overall qualifications. General Dynamics – Bath Iron Works also provides a variety of benefits including medical & dental insurance coverage, 401(k) retirement savings plan, flexible spending accounts/HSAs, life and disability insurance, company paid holidays, paid time off (PTO), health coaching, athletic trainers, employee assistance programs and onsite health services.

 

Provide Workers’ Compensation Claims Administration support of BIW's self-insured/self-administered Workers' Compensation program.  Review of new medical encounters for timely setting up of claims and processing Adjuster instructions. Accurate and timely filing of State and Federally mandated forms in accordance with strict agency rules and regulations. Provide guidance and assistance to injured employees as required and interact with State and Federal agencies to provide claim information. Provide daily out of work and return to work information to relevant internal departments. Calculate and enter indemnity checks for injured employees as well as checks for mileage and out-of-pocket expenses. Perform the weekly check run including posting, balancing, printing and mailing of all checks being issued as needed.  Process medical invoices in accordance with the Maine WC Board fee schedule as well as payments.

 

Operating under the BIW Business Operating System (BOS), the (Specialist) ensures compliance with safety, quality, and performance standards while coordinating with other key stakeholders to meet overall milestones.

 

Key Responsibilities

 

Safety Leadership:

• Identify and report out any and all opportunities for prevention or mitigation of injuries during the review of claims and related data & reports. 

Project Execution:

• Participate in the analysis of compliance reports and provide feedback as required.
• Assist in the process of internal and external financial and claim audits as required.
• Review for reasonableness and approval of medical invoices in accordance with treatment plans.

Training and Development:

• Keep up to date on State and Federal laws as well as Medicare reporting requirements.
• Assist and educate employees and supervisors/managers on respective roles and responsibilities in managing WC claims.

Team Collaboration and Communication:

• Work closely with Medical Dept., Operations, Human Resources, Labor Relations, and other functional areas to promote early return to work
• Other administrative duties as assigned by the Director of Risk Management.

Continuous Improvement:

• Regular participation in process improvement and/or change management activities within the department and as part of larger teams.
• Identify opportunities for continuous process improvement and work closely with team members toward achieving same.
• Interact with State and Federal agencies to provide claim data and answer questions.

 

Required/Preferred Education/Training

• Associate’s degree in business administration or equivalent together with strong work experience required.
• Bachelor’s degree in business administration or equivalent combination of education and experience preferred.

Required/Preferred Experience

• 2 years’ experience in WC Claims Administration or Disability Management Administration preferred.
• Advanced knowledge of MS Office required.
• Strong organizational, interpersonal, and communication skills required.
• Experience with Human Resources Information Systems, Claim Management System, or other business systems required.
• Knowledge of Federal and State regulatory compliance requirements preferred.
• Experience in process improvement and/or change management a plus.
• Experience with PeopleSoft or WFM a plus.
• Self-motivated & team-oriented.
• High attention to detail required.
• Able to maintain confidentiality of highly sensitive information.