|Reference # : ||18-37788
||Title : ||Worker's Compensation Representative|
San Francisco, CA
|Experience Level : ||
||Start Date / End Date : ||07/09/2018 / 07/08/2019
| Description |
Artech is currently seeking to add to the below position
Job Title : Worker's Compensation Representative
Job ID : 10279
Location :77 Beale Street,San Francisco, CA, 94105
Duration :12 Months contract
Must have a high School Diploma or equivalent Required to sit an estimated 85% of the work shift while performing job duties at a desk and while working at a computer terminal. Must be able to lift, and carry case files weighing up to approximately 12 pounds and associated materials short distances Must possess a valid California Drivers License Must have understandable speech in order to effectively communicate with co workers, employees, the general public, etc. Must be computer literate, and proficient in MS Office Suite Must be capable to handle lead responsibility for the adjustment of all litigated claims.
Must be experienced in maintaining a current diary, which includes a working case strategy with all issues moving toward conclusion.
TOP THREE 1) Relevant job experience. 2) Customer Service Skills 3) Organization
The following are the Major Areas of Responsibility and Essential Physical functions for the Journey Level Workers'
Compensation Representatives: Workers' Compensation Case Management Manages, reviews and identifies all issues and adjust worker's compensation claims in a timely, accurate, and cost effective manner.
Maintains appropriate diary on all claims. Establishes and consistently updates the plan of action. Documents file and VOS (Valley Oaks System, electronic case management system). Staffs complex issues with WCS.
Communicates with internal and external clients in a clear, concise manner to appropriately administer benefits.
Provides periodic field visits and presentations. Handles all cases to meet Division of Workers' Compensation Audit Unit rules and regulations.
Establishes and maintains accurate case reserves with appropriate written documentation in VOS.
Maintains a 30 day diary, or sooner if appropriate, for medical care follow up on Light Duty cases.
If Light Duty exceeds 180 days, evaluate SJDB exposure. Completes Workers' Compensation Payroll Authorization Report (PAR) to meet weekly payroll deadline (for payment of Temporary Disability Benefits).
Maintains, directs, and reconciles a bi weekly diary for Temporary Disability, Permanent Disability, and Life Pension cases to ensure accuracy; if indicated. Solicits wage information from payroll as appropriate.
Solicits payroll information from client department as appropriate.
Process benefit notices as required. Identifies, processes and tracks utilization review referrals.
Updates VOS notes and if appropriate provides medical authorization for injured employees.
Also, provides answers or seeks to resolve claims inquiries as needed by clients. Request/subpoena records.
Index all new claims and re index every 6 12 months.
Researches and obtains accident report, if appropriate, for the "no accident report correspondence" or advises sender if not PG&E related.
Performs and completes investigation with regard to AOE/COE issues and complies with 90 day AOE/COE requirements.
Obtain WCS approval on delays and denials.
Closes files pursuant to standard procedures.
Workers' Compensation Settlements and Litigation Evaluates medical reports, prepares ratings, and negotiates settlements. Aggressively pursues settlement for all cases, litigated/non litigated, with anticipated permanent disability and/or future medical care issues.
Initiates QME process and completes benefit notices as mandated. Performs case analysis/settlement evaluation to properly assess facts, develop strategies, and comply with legally mandated time parameters. Staffs all legal referrals with WCS after performing case analysis.
Proactively directs case strategy and follows up on legal referrals.
Obtains settlement authority, as required, and completes required documents.
Evaluates and handles In Pro Per/Represented cases at WCAB Hearings
Please apply on our company website (www.artechinfo.com) with reference to job ID, or contact me at Pradeep.V@artechinfo.com / 973.507.7539
Team Lead – Staffing
Artech Information Systems LLC
360 Mt. Kemble Avenue, Suite 2000 | Morristown, NJ 07960
Office: 973.507.7539 | Fax: 973.998.2599
Email: Pradeep.V@artechinfo.com | Website: www.artechinfo.com
About Artech Information Systems LLC
Artech is an employer-of-choice for the last 25 years to over 7,500 consultants across the globe. We recruit top-notch talent for over 70 Fortune and Government clients coast-to-coast across the U.S., India, and China. We are #1 Largest Woman-Owned IT Staffing Firm in the US and this may be your opportunity to join us! For more check: www.artechinfo.com
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