Claims Review Specialist - Workers Compensation

Aerotek has an immediate opening for a Claims Review Specialist - Workers Compensation at the corporate office in Tempe, AZ. About this role...Full Time | Monday - FridayHybrid Schedule | 4 days in office - 1 day remoteJob Summary:Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek’s workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently.Essential Functions:Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims. Monitor to ensure that TPA follows appropriate state workers compensation laws and defensesWithin the scope of authority, reviews and authorizes worker’s compensation settlement offers to be made by the TPAEffectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurateReviews costs associated with all claims handling and developing strategies to improve performanceWorks with TPA to move claims toward closurePartners with Safety, Human Resources and Corporate Legal to drive claims managementMakes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigatorCoordinates the employee’s release to transitional duty with the Return-to-Work Specialist and the Field Office.Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trialInitiate subrogation where appropriate with management’s authorizationPrepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of ActionsConducts bi-annual audits to ensure TPA is meeting their best practices requirementsReview reserves and provide authorization to TPA, where appropriate within authorityReviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustmentsMonitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as neededParticipates in developing strategies to reduce claims frequency and severityEstablishes and maintains a file and diary on all open claimsParticipates in communicating claims trends to Regional Safety ManagerWorking with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and processAttends training sessions, conferences, and workshops to keep abreast of current practices, programs, and legal issues for the purpose of conveying and/or gathering information required to perform functionsAuthority level for settlements up to $70,000Authority level for reserves up to $80,000Qualifications:High school diploma and 3 years work experience in insurance, workers compensation claim management or risk management orAssociate in Arts / Sciences and 2 years' experience in workers compensation, or risk management or related field orBachelor's Degree with 2 years' work experience in insurance, workers compensation claims management or risk managementAbility to learn TPA system & generate requested reports