UNIV - Workers’ Compensation Coordinator - Department of Insurance Services

Job Description Summary

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Job Description

Job Description 

Workers’ Compensation Claim & Case Coordinator 35% 

• Assist in processing and monitoring of assigned MUSC and /or MUHA injury claims, including insured and self-insured claims, from notification of potential claim until closure of claim. 

• Provide technical and professional assistance in case management, transition back to work assistance, claim investigations, and settlements. 

• Case management can include scheduling of appointments, obtaining current medical information, and assisting the injured employee by providing a liaison with a State Accident Fund (SAF) adjuster and/or nurse case management vendor. Submits timely acknowledgements of new injury reports to injured Care Team Member and Manager as appropriate.  

• Facilitate transition back to work initiatives for injured workers to include assisting managers and coordinating alternative assignments or modified duty assignments when appropriate. Ensure continued communication with injured worker, manager of injured worker, HR, EHS, SAF, and nurse case management vendor. 

• Respond promptly to inquiries from injured worker, manager of injured worker, EHS, HR, SAF, and nurse case management vendor . 

• As directed, act as MUSC/MUHA representative for depositions, conferences, mediations, or hearings, working with assigned attorneys, employees, and carrier representatives, as necessary. 

Injury & Claims Data Analyst 35% 

• Maintain all assigned MUSC and MUHA Injury data as required by regulatory bodies such as OSHA and Joint Commission. Ensure accurate data for determining OSHA recordability is documented.  Prepare and manage OSHA Logs. 

• Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in injury databases/claims management system for analysis and dashboard reporting for MUSC and/or MUSC Health System and in support of the Insurance Services shared service agreements. 

• Maintain database of modified duty assignments. 

• Manage database of charges for analysis and prepare reports as requested. 

• Prepare injury-related reports at required intervals as requested by leadership for various organizations and departments. Ensure accurate data related to workplace injuries and workers’ compensation claims is maintained in claims management system/injury databases for analysis and dashboard reporting. 

Self-Insured Claims Billing Coordinator 20% 

• Coordinate billing of all MUSC and MUHA self-insured workplace injury claims. 

• Respond to facility, physician, and pharmacy internal billing representatives regarding billing. 

• Ensure accurate invoicing and payment based on current workers ‘compensation payment schedules for facility, physician, and pharmacy charges. Prepare and submit bills for processing in a timely manner.  

• Respond promptly to inquires regarding billing issues and escalate to appropriate hospital and physician billing representatives and/or SAF as appropriate. 

Affiliate Support 5% 

• Provide continuous support of aforementioned duties to MUHA Regional Health Network hospitals as needed. 

• Assist in ensuring out-of-state, remote workers are adequately insured and claims managed. 

Other duties as required 5% 

• Other duties as required. Carries out special projects, serves on various committees as needed, and performs assignments as directed by the Workers’ Compensation Manager and Insurance Services leadership. This position is considered an essential position. 

KNOWLEDGE, SKILLS, AND ABILITIES 

Knowledge of laws, regulations, policies and procedures relevant to workers' compensation. Ability to interpret and apply applicable laws, regulations, policies and procedures. 

Employee should be familiar with the S.C. Workers' Compensation Law and OSHA injury reporting requirements. 

Strong Data Analysis skills. 

Ability to establish and maintain effective working relationships. 

Ability to communicate effectively, both orally and in writing. 

Strong planning and organizational skills.   

Demonstrated ability to effectively prioritize competing tasks and manage multiple responsibilities in a fast-paced environment. 

Proficiency in Microsoft Office applications, including Excel, Word, PowerPoint, and data reporting tools 

Excellent customer service, verbal, and written communication skills. 

Employee works under the direct guidance of the Workers’ Compensation Manager but must be able to work independently with latitude to use discretion and sound judgment in making decisions. 

Additional Job Description 

Minimum Requirements: A bachelor's degree and two years relevant program experience. Physical Requirements: (Note: The following descriptions are applicable to this section: Continuous - 6-8 hours per shift; Frequent - 2-6 hours per shift; Infrequent - 0-2 hours per shift) Ability to perform job functions in an upright position. (Frequent) Ability to perform job functions in a seated position. (Frequent) Ability to perform job functions while walking/mobile. (Frequent) Ability to work indoors. (Continuous) Ability to work outdoors in all weather and temperature extremes. (Infrequent) Ability to work in confined/cramped spaces. (Infrequent) Ability to perform job functions from kneeling positions. (Infrequent) Ability to squat and perform job functions. (Infrequent) Ability to perform 'pinching' operations. (Infrequent) Ability to fully use both hands/arms. (Frequent) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent) Ability to reach in all directions. (Frequent) Possess good finger dexterity. (Continuous) Ability to maintain tactile sensory functions. (Continuous) Ability to lift and carry 15 lbs., unassisted. (Infrequent) Ability to lower objects, up to 15 lbs., from height of 36 inches to floor level, unassisted. (Infrequent) Ability to push/pull objects, up to 15 lbs., unassisted. (Infrequent) Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) Ability to see and recognize objects close at hand. (Frequent) Ability to see and recognize objects at a distance. (Frequent) Ability to determine distance/relationship between objects; depth perception. (Frequent) Good peripheral vision capabilities. (Continuous) Ability to maintain hearing acuity, with correction. (Continuous) Ability to perform gross motor functions with frequent fine motor movements. (Frequent) 

Additional Job Description

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees