Workers' Compensation Specialist

Concentra is recognized as the nation’s leading occupational health care company.

With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of
America’s workforce, one patient at a time. With a wide range of services and proactive approaches to
care, Concentra colleagues provide exceptional service to employers and exceptional care to their
employees.

Responsible for the organizational-wide workers compensation claim management and oversight.
Collaborates with Operational, Clinical, Human Resources, Legal and department managers in effecting
fulfillment of organizational goals for risk management program.

• Serves as the primary internal point of contact for all colleague injury claims and Workers’
Compensation matters.
• Responsible for managing workers’ compensation claims in compliance with all state and federal
laws.
• Reviews intake of work comp claims and ensures data is accurate and complete.
• Communicates with external claims adjusters to enable the successful settlement and disposition
of claims.
• Communicates with employees, medical providers, and TPAs throughout the claims process.
• Coordinates with HR to support return-to-work and transitional duty work when appropriate.
• Monitors and evaluates TPA performance, ensuring compliance with service standards.
• Coordinates with the Safety and Security department on claim trends and root cause analysis.
• Ensures accurate and timely submission of First Reports of Injury and all necessary
documentation.
• Oversees TX Non-Sub TPA and completes DWC forms.
• Documents and communicates claim activities timely and effectively.
• Participates in claim reviews with carriers, adjusters, and TPAs.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or
responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may
change at any time with or without notice.

• Education Level: Bachelor’s Degree ; Major: Risk Management, Occupational Safety and Health or a related field of study
• In lieu of higher education, the ratio is 1:1 meaning one year of college equals one year of work experience and vice-versa.
• Customarily has at least three (3) years of experience in risk management, working with internal and external parties through work comp claims management processes.
• Experience in occupational safety and health, risk management, and/or insurance claim management is preferred.

Job Related Skills / Competencies

• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• General insurance claim process knowledge. Extensive administrative experience, with demonstrated attention to detail, and excellent organizational, interpersonal, and written and oral communication skills.
• Knowledge of federal and state legal statutes relating to risk management; principles and practices of risk management and loss control programs; medical and technical terminology used in industrial injury and illness cases.
• Ability to analyze claims in accordance with applicable laws and Organization procedures and policies; present arguments and statements of fact in written and oral forms; exercise independent judgment; establish and maintain working relationships wit managers, employees, attorneys, medical personnel, and others; read and understand complex reports, laws, and case histories; and prepare oral and written reports and recommendations.
• Ability to coordinate a variety of components, including safety education, incident/accident prevention, and loss control programs, with appropriate departmental personnel; understand complex reports, laws, and case histories; perform surveys and investigations relating to the cause of accidents; prepare oral reports and written documents and recommendations; learn the fundamentals of workers' compensation and civil liability law and claims handling procedures; establish and maintain working relationships with managers, employees, attorneys, medical personnel, and others; compile statistical data and make inferences relating to loss experience and control.
• Ability to independently make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions.
• Skill in the use of computer software, especially Microsoft Office Suite.

Employee Benefits

• 401(k) Retirement Plan with Employer Match
• Medical, Vision, Prescription, Telehealth, & Dental Plans
• Life & Disability Insurance
• Paid Time Off
• Colleague Referral Bonus Program
• Tuition Reimbursement
• Commuter Benefits
• Dependent Care Spending Account
• Employee Discounts

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation, if required.

*This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management*

Concentra is an Equal Opportunity Employer, including disability/veterans