Under general direction, ensures timely processing of workers’ compensation claims; evaluates accident reports to determine accuracy and completeness and to ensure adequate investigation; ensures that the city is in compliance with applicable laws and regulations; provides training and guidance to claims coordinators in all departments..
- Evaluates accident reports, ensuring the timely processing of medical bills and temporary total disability benefits; reviews medical reports, witness statements, department investigation results, and other documentation.
- Maintains subrogation records and files for those incidents involving third parties. Sends subrogation letters to third parties in an effort to obtain reimbursement of monies spent by the city for medical treatment, time loss, and awards and settlements paid; submits amounts paid for medical treatment and/or temporary total disability benefits to the State Attorney’s Office in order to seek reimbursement in cases where criminal charges have been filed.
- Compiles facts and data regarding accident reports and filed cases.
- Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued; authorizes payment of medical bills and temporary total disability benefits upon receipt of proper documentation.
- Advises and/or assists departments in conducting investigation of accident reports, including interviewing of witnesses and procurement of relevant documentation.
- Reviews accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident; advises departments of trends in injuries and proper safety procedures that may result in reduction of injuries; provides department with information that will aid in reducing accidents and improve safety.
- Trains claims coordinators in the proper procedures and forms to be utilized in workers’ compensation matters and the preparation of accident reports, notices of absence, and notices of return to work in accordance with city regulations and the Workers’ Compensation Act.
- Documents telephone conversations, witness statements, medical reports, accident investigation results, and payment of medical bills; prepares summaries of medical reports; ensures that state Industrial Commission forms are properly prepared and filed.
- Requires knowledge, skills, and mental development equivalent to the completion of four (4) years of college with courses in medical terminology or anatomy and three (3) years’ experience in medical claims analysis or any equivalent combination of training and experience.
- Working knowledge of the Workers’ Compensation Act and other applicable state/federal statutes and regulations.
- Working knowledge of medical terminology, body systems, and/or impairments and their disabling effects.
- Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills.
- Good judgment in interpreting medical facts presented by a physician and applying these facts in determining an individual’s capacity to engage in gainful occupation.
This position is exposed to both office and industrial meat processing environments. Temperatures on the product floor are very cold with wet / slippery floors, industrial equipment and machinery.
The preceding job description has been designed 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 qualification required of employees assigned to this job.