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Job Type:
Regular
Scheduled Hours:
20
Why You'll Love Working with St. Elizabeth Healthcare
At St. Elizabeth Healthcare, every role supports our mission to provide comprehensive and compassionate care to the communities we serve. For more than 160 years, St. Elizabeth Healthcare has been a trusted provider of quality care across Kentucky, Indiana, and Ohio. We're guided by our mission to improve the health of the communities we serve and by our values of excellence, integrity, compassion, and teamwork. Our associates are the heart of everything we do.
Benefits That Support You
We invest in you - personally and professionally.
Enjoy:
- Competitive pay and comprehensive health coverage within the first 30 days.
- Generous paid time off and flexible work schedules
- Retirement savings with employer match
- Tuition reimbursement and professional development opportunities
- Wellness, mental health, and recognition programs
- Career advancement through mentorship and internal mobility
Job Summary:
Assists with the management of St. Elizabeth Healthcare System's FMLA/MLOA, WC and STD benefit programs. The position works closely with the Manager of Employee Leaves in the administration of the system's leave and benefit related programs and policies. This position is responsible for the management of complex claims through successful resolution.
Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.
Job Description:
Job Duties:
- Proactively manages an inventory of complex Worker's Compensation claims and Short-Term Disability claims. Reviews progress of claim with employees and providers to establish an action plan for return to work.
- Initiates, coordinates and ensures early return-to-work efforts with the employee and supervisor.
- Ensures timely and accurate decisions and benefit provision
- May establish reserves and authorize treatment/payments within authority guidelines
- Utilizes computer software programs to track leaves and provide reports to management.
- Provides ongoing updates to managers/supervisors as to status of leave.
- Coordinate with defense counsel on litigation of claims, providing records and reports as necessary
- Investigates and researches case law and technical assistance publications to ensure accuracy and integrity of claims administration.
- Regularly handles confidential information while maintaining strict confidentiality and protecting from unauthorized disclosure.
- Acts as a resource for claims questions and guidance.
- May require travel to physicians, other St. Elizabeth locations or hearings.
- Performs other duties as assigned.
MINIMUM REQUIREMENTS
Education, Credentials, Licenses:
- High School Diploma / GED
- Licensed Adjuster for the state in state worked
- OR
- Licensed Nurse Case Manager for the state in state worked (if eligible, must have a compact multi-state RN license in primary state of residence)
Specialized Knowledge:
- Extensive computer knowledge including Microsoft Office
- Excellent organizational and interpersonal skills.
- Knowledge of disability plans administration
- Excellent oral and written skills
- Effective analytical and interpretive skills
- Ability to work independently as well as in a team environment
- Basic math skills required
- Understands medical terminology
- Understands treatment plans and utilizes best practice guidelines in formulating plans of action
- Ability to effectively deal with difficult situations
- Advanced knowledge and experience with KY workers' compensation
- Demonstrated ability to coordinate decision-making and problem-solving
- Knowledge and experience with FMLA and STD administration process
Kind and Length of Experience:
- 5 years directly related adjusting experience including: workers' compensation claims adjuster experience
DESIRABLE
Education, Credentials, Licenses:
Specialized Knowledge:
- Familiar with HR database software (i.e., Workday).
- Familiar with OH, KY, IN Workers' Compensation regulations
Kind and Length of Experience:
- Ten years workers' compensation and disability claims experience
FLSA Status:
Exempt
Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.