Claims Specialist – Workers Compensation

Job Description Summary:

To administer and coordinate the handling of work-related injury claims and maintain safety statistical information for regulatory compliance in every state where Swinerton works (OSHA, Cal-OSHA, etc)

Job Description:

ESSENTIAL RESPONSIBILITIES AND DUTIES:

Review and assess all reports of industrial and work-related injuries; ascertain compensability and injury validity, investigate claims, OSHA recordable status, record decisions made and report to appropriate insurer(s) as needed.
Procure and prepare all necessary paperwork and injury information as required for insurer, defense and regulatory compliance; Evaluate and determine work status; coordinate medical needs and successful return to light/modified duty.
Interview injured employees, physicians, and witnesses as well as other potential field investigative work.

Typical Functions

Review and approve the costs and resolution of first-aid injuries, and maintain records
Ensure workers compensation programs and policies are followed.
Discuss cases with employees, managers, insurance carriers, attorneys, physicians, representatives of employee groups and other persons involve in Workers Compensation. Coordinate and conduct claim reviews with insurers and broker.
Coordinates and monitors vocational rehabilitation; liaises between management, the rehabilitation counselor, and the injured employee; attends all case management conferences as required; files and maintains required documentation.
Monitor and provide updates to management (as appropriate) claim activity and loss data, including the authorization of reserves and settlements with approval from department head or others as needed. Assists management with resolving questions and issues pertaining to workers compensation claims.
Continue development of available medical facilities; Notify Drug testing MRO of additions for collection site listing; screen/tour potential medical facilities; Assign primary clinics for project sites in conjunction with guidance from insurer(s) and identify after-hour facilities.
Develop injury experience detail for OSHA statistical requirements; Create and distribute OSHA 300 and 301 logs for all divisions and affiliated companies
Maintain and update the workers compensation information on Swinerton internal website(s); provide training and support as needed. Ensure accurate information about workers compensation insurance is available to all jobsite offices, division offices and employees.
Assist outside counsel and Swinerton Human Resources with research and document procurement related to industrial injuries
Compose letters, memos, reports, procedures, etc. as required to manage insurance claims, industrial injuries, and other job duties.
Complete other responsibilities as assigned

MINIMUM SKILLS OR EXPERIENCE REQUIREMENTS:

Four year degree from an accredited university preferred and six years property/liability claims experience or commensurate industry experience.
Significant experience in construction industrial injury claims and case management, especially in states where Swinerton companies work and operate.
Computer proficiency with MS Office Suite and RMIS
Adherence to Swinerton core values and Company policies and procedures
Excellent written and verbal English communication skills, including business writing skills, public speaking in a group setting and professional telephone manner
Reliability, dependability and flexibility