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Posted June 10th

Workers Compensation Senior Manager

New York, New York


Empire Merchants logo

Employer

Empire Merchants

Industry

Distributor

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Posted June 10th

Workers Compensation Senior Manager

New York, New York

Function

Other

Experience

Other

Type

Full Time

LOCATION:

Hybrid: Empire Merchants NY, Brooklyn/Astoria Office & Remote

POSITION SUMMARY

Under the supervision of the Human Resource Director the Workers Compensation Manager is responsible for ensuring the business is compliant with the state specific Workers' Compensation regulations and business policies and guidelines. They will lead to effort to reduce WC costs and set up an infrastructure to maintain an appropriate level. They will act as the point of notification and contact for associates regarding any incident or injury that could or has resulted in a Workers' Compensation claim.

ESSENTIAL POSITION DUTIES AND RESPONSIBILITES
  • Point of contact for all documentation regarding incident. This includes internal safety notify and investigation details as well as any health information relevant to the claim from outside medical providers and treatment notes. Health information is limited to medical related to the injury.
  • Assess the medical, vocational, behavioral, etc. needs of an injured associate via a combination of face to face, telephonic and written correspondence as needed.
  • Provide all relevant documentation regarding work related incidents to Safety, onsite healthcare providers, Leave of Absence (LOA) team and TPA to assist in the determination of compensability, recordability and recording keeping requirements. This includes determining mechanism of injury, work restrictions, and managing the information related to work related injury/illness.
  • Initial and ongoing point of contact to internal and external business partners for the duration of the claim.
  • Point of contact for all written and telephonic correspondence regarding the claim.
  • Communicate with providers, both internal and external to review treatment notes, ask for clarification, when necessary, follow-up after initial appointments as well as scheduling appointments in conjunction with TPA if a referral to a specialist is required.
  • Ensures confidentiality of Workers' Compensation claims records; including relevant health information related to the claim.
  • Ensures that the TPA manages the claims diligently, partners with Risk Management and Legal (internal and external) to manage relevant claim details, implement plan for timely resolution of claims.
  • Review medical notes as they relate to the claim and treatment to verify appropriateness.
  • Review claims together with TPA for causation and possible subrogation opportunities.
  • Partner with multiple departments to coordinate and manage Return to Work programs for employees to ensure that work restriction and transitional work guidelines are being adhered to. Provide transitional work letter to associates.
  • Maintain consistent uniform records for each claim.
  • Maintain and update the transitional work tracker form on a weekly basis.
  • Review all open claims every 30 days for opportunities for claims management and partner with all relevant stakeholders on a plan of action.
  • Partner cross functionally to proactively address any re occurring root causes.
  • Schedule, develop agenda and host all conference calls and claim reviews with TPA.
  • Review all medical providers and/or panels annually and ensure business is in compliance with state guidelines regarding panels. Where applicable, ensure all appropriate authorization and forms are signed and processed.


JOB REQUIREMENTS

Education, Certification and/or Licenses:

• 6+ years of direct workers' compensation experience
  • Bachelor's degree preferred
  • Demonstrated knowledge of NY workers' compensation claims management related laws and medical and legal terminology
  • Union experience is a must
  • Prior experience in the warehousing, third party logistic and/or distribution centers preferred.
  • Associates in Risk Management or other insurance/claim related designations
  • High comfort with managing and communicating claim trends and information by using various data sources
  • Analytical, data driven, experience in building WC dashboards/reporting
  • Experience in reducing WC costs
  • Excellent verbal communication skills and a positive approach to customer interactions
  • Successful history of working in a fast paced, high-volume environment
  • Ability to think critically to solve problems

PHYSICAL DEMANDS

While performing the duties of this job, the employee is regularly required to use hands to finger, handle or feel, reach with hands and arms, stoop, kneel, crouch or crawl and talk ort hear. The employee frequently is required to stand, walk, sit and climb or balance. The employee may regularly lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

WORKING CONDITIONS AND ENVIORNMENT

While performing the duties of this job, the employee is regularly exposed to a normal business office environment. There is limited travel required.
Location
New York, New York