$33.18-$49.77 Hourly / $5,751.20-$8,626.80 Monthly / $69,014.40-$103,521.60 Yearly
Employees in this class are responsible for participating in planning, organizing, and conducting risk management activities for the municipal government. Under general supervision, employees perform assignments of considerable difficulty requiring the exercise of reasonable initiative and independent judgment in drafting, interpreting, and implementing rules, regulations, policies, and procedures. Work is performed in accordance with state and federal guidelines, legislation, accepted practices, existing arrangements, and union contracts with which the municipal government must comply. Employee participates in administrative and technical work reviewing, tracking, reporting on data and injury trends in the self-insured workers' compensation claims program. Responsible for working with Loss Prevention team and others to reduce injuries. Work involves serving as liaison between attorneys, Third Party Administrator (TPA), departments and injured employees. Responsible for initial and ongoing contact with injured employees. Participates in meetings to explain workers' compensation benefits to administrators, managers, supervisors and employees.
Under the direction of the Risk Manager the incumbent will coordinate the self-insured Workers' compensation Program, serve as internal contact for vendors, supervisors and employees regarding workers’ compensation indemnity, medical benefits and Return-to-Work (RTW) processes in conjunction with the TPA.
Work is reviewed while in progress and upon completion through conferences, written reports and results obtained.
Advise departments of workers’ compensation timekeeping procedures and codes as needed. Compile reports using available data to determine effectiveness of Risk, TPA services and department programs. Review leave reports in relation to workplace injury.
Submit request for quarterly claim status review to TPA for case updates. Obtain copies of status reports at quarterly claims review meetings and track reviewed claims. Review TPA claims management system for all new claims as they are reported. Track new claims through the process and provide internal status updates. Monitoring all claims as needed.
Copy/Inform supervisors of their injured worker’s claim status based on documents and status updates provided by the TPA. Monitor new claims and make initial contact on behalf of Risk Management to Department, Supervisor, and Employee.
Reviews accident reports and all available data to identify patterns of injury and working with the Safety Staff determine whether unsafe conditions contributed to the accident; advise departments of trends in injuries and proper safety procedures that may result in reduction of injuries; provide departments with information that will aid in reducing accidents and improve safety.
Collect and compile all necessary information for potential settlement of claims.
Ensure all posters, notices, and forms are current, shared and posted.
Work with Risk staff to assist with redesign, implementation and facilitation of the internal Return-to-Work Program.
Performs related work as required.
Working knowledge of: The Florida Workers’ Compensation laws and other applicable state/federal statutes and regulations. Medical terminology, body systems and/or impairments and their disabling effects. Claim determinations and management. Office procedures and files. Working knowledge of the tenets of supervision and motivation of employees.
Some knowledge of: Return-to-Work, Rehabilitation programs and practices and claim settlement.
Ability to: Obtain facts that ensure claims information is complete and accurate. Evaluate and report on all medical and lost time claims regarding payment of temporary total, permanent total disability benefits, medical bills and return to work. Good judgment in interpreting medical facts contained in claim files as presented by a physician and applying these facts in determining an individual's capacity to engage in occupation according to the most recent position description. Read, assimilate and recall with marked proficiency facts, figures and descriptions, and to search for and obtain claim, job and rehabilitation information. Analyze, compile and present data relating to workers' compensation claims, cost and program effectiveness. Communicate effectively with various audiences, prepare and submit clear, concise and timely oral and written reports. Accept and adapt to change in a positive and productive manner. Ability to maintain satisfactory working relationships with co-workers, employees, departments, TPA and the general public.
Skill in: Organizing work to achieve maximum efficiency Operation of computers and use of software to include Word and PowerPoint. Must be an Expert with Excel spreadsheet. Requires critical thinking