The University of Chicago Medicine
Workers' Compensation Coordinator (Case Manager)
The University of Chicago Medicine, Chicago, Illinois, United States, 60290
Job Description
Join one of the nation’s most comprehensive academic medical centers,
UChicago Medicine , as a
Workers’ Compensation Coordinator
in our
Occupational Health Department . This hybrid position requires travel to our Hyde Park campus as needed.
The Workers’ Compensation Coordinator is responsible for management of the workers’ compensation program from the initial investigation of injuries through to closure of the claims. Reviews claim data and identifies trends, root causes, or other areas of opportunity to decrease injury, reduce cost, and improve program administration. Ensures correct payment of disability benefits to injured employees. Approves wire transfer requests from the third-party administrator for payment of program expenses. Provides case management services for injured employees. Manages modified Duty Program for transitional work assignments. Provides settlement authorization within budget authority for litigated claims.
Essential Job Functions
Reviews claim data and identifies trends, root causes, or other areas of opportunity to decrease injuries, reduce costs, and improve program administration.
Composes reports and correspondence to ensure communication between employees, UCMC defense attorneys, managers, HR, and WC TPA.
Runs monthly reports for department work injury data.
Coordinates the transitional duty program in collaboration with department managers.
Reviews occupational injury/illness and workers compensation-related information and reports this to the appropriate staff and regulatory agencies (OSHA 300 log and IL WC Commission).
Oversees establishment of workers’ compensation claims with third party administrator (TPA).
Is primary contact for WC TPA.
Provides expert case management for injured workers.
Consults with HCP to discuss treatment plans, strategies, and RTW status; authorizes treatment for providers within and outside UCM, determines need for IMEs, UR, surveillance, and vocational rehab; assigns litigated claims to attorneys.
Reviews and ensures accurate and prompt payment of TTD by TPA.
Responsible for updating, monitoring, and communicating any service level agreements issues or changes with the WC TPA, outside counsel, or other vendors that provide WC services for UCMC employees.
Approves weekly GB Funding requests for payment of GB services.
Participates in leadership development programs, committee and subcommittee work: Safe Patient Handling, Institutional Safety, and Occ Med Safety Sub-committee.
Refers employees to Sedgwick for STD or Leave Administration when a WC claim is denied.
Audits medical charges from UCOM, Pharmacy, Radiology, and other internal hospital charges for appropriate billing; acts on incorrect charges in relation to Workers’ Compensation Program.
Coordinates quarterly claim reviews with WC TPA and outside counsel.
Grants settlement authority per UCMC finance policy.
Required Qualifications
Bachelor’s degree (nursing, Allied Health, or related field preferred).
Minimum of 3 years of prior experience in Workers Compensation Administration or a similar role.
Current knowledge of laws and regulations governing worker and worksite health and safety (i.e. OSHA, Illinois workers' compensation Act, ADA, FMLA).
Knowledge of computer software and databases (e.g. Kronos, Oracle, EMRs).
Knowledge of IL WC laws and regulations.
Ability to analyze complex medical information.
Good written and verbal communications skills and ability to work with diverse stakeholders including employers, doctors, TPAs, attorneys, and claimants.
Preferred Qualifications
Registered Nurse License.
Certified Case Manager or certified WC specialist/professional.
Advanced degree.
Position Details
Job Type/FTE: Full Time (1.0 FTE).
Shift: Day.
Job Location: Flexible (Hyde Park).
Unit/Department: Occupational Health – Hyde Park.
CBA Code: Non-Union.
#J-18808-Ljbffr
Join one of the nation’s most comprehensive academic medical centers,
UChicago Medicine , as a
Workers’ Compensation Coordinator
in our
Occupational Health Department . This hybrid position requires travel to our Hyde Park campus as needed.
The Workers’ Compensation Coordinator is responsible for management of the workers’ compensation program from the initial investigation of injuries through to closure of the claims. Reviews claim data and identifies trends, root causes, or other areas of opportunity to decrease injury, reduce cost, and improve program administration. Ensures correct payment of disability benefits to injured employees. Approves wire transfer requests from the third-party administrator for payment of program expenses. Provides case management services for injured employees. Manages modified Duty Program for transitional work assignments. Provides settlement authorization within budget authority for litigated claims.
Essential Job Functions
Reviews claim data and identifies trends, root causes, or other areas of opportunity to decrease injuries, reduce costs, and improve program administration.
Composes reports and correspondence to ensure communication between employees, UCMC defense attorneys, managers, HR, and WC TPA.
Runs monthly reports for department work injury data.
Coordinates the transitional duty program in collaboration with department managers.
Reviews occupational injury/illness and workers compensation-related information and reports this to the appropriate staff and regulatory agencies (OSHA 300 log and IL WC Commission).
Oversees establishment of workers’ compensation claims with third party administrator (TPA).
Is primary contact for WC TPA.
Provides expert case management for injured workers.
Consults with HCP to discuss treatment plans, strategies, and RTW status; authorizes treatment for providers within and outside UCM, determines need for IMEs, UR, surveillance, and vocational rehab; assigns litigated claims to attorneys.
Reviews and ensures accurate and prompt payment of TTD by TPA.
Responsible for updating, monitoring, and communicating any service level agreements issues or changes with the WC TPA, outside counsel, or other vendors that provide WC services for UCMC employees.
Approves weekly GB Funding requests for payment of GB services.
Participates in leadership development programs, committee and subcommittee work: Safe Patient Handling, Institutional Safety, and Occ Med Safety Sub-committee.
Refers employees to Sedgwick for STD or Leave Administration when a WC claim is denied.
Audits medical charges from UCOM, Pharmacy, Radiology, and other internal hospital charges for appropriate billing; acts on incorrect charges in relation to Workers’ Compensation Program.
Coordinates quarterly claim reviews with WC TPA and outside counsel.
Grants settlement authority per UCMC finance policy.
Required Qualifications
Bachelor’s degree (nursing, Allied Health, or related field preferred).
Minimum of 3 years of prior experience in Workers Compensation Administration or a similar role.
Current knowledge of laws and regulations governing worker and worksite health and safety (i.e. OSHA, Illinois workers' compensation Act, ADA, FMLA).
Knowledge of computer software and databases (e.g. Kronos, Oracle, EMRs).
Knowledge of IL WC laws and regulations.
Ability to analyze complex medical information.
Good written and verbal communications skills and ability to work with diverse stakeholders including employers, doctors, TPAs, attorneys, and claimants.
Preferred Qualifications
Registered Nurse License.
Certified Case Manager or certified WC specialist/professional.
Advanced degree.
Position Details
Job Type/FTE: Full Time (1.0 FTE).
Shift: Day.
Job Location: Flexible (Hyde Park).
Unit/Department: Occupational Health – Hyde Park.
CBA Code: Non-Union.
#J-18808-Ljbffr