Senior Worker's Compensation, Accommodation Claims Management
Full Time
Grand Rapids, MI
Posted
Job description
Job Summary
Responsible management of claims within the Integrated Disability Management department. Managing Worker's Compensation claims and accommodations within various departments. Also supporting of leave management for Physician and HR related claims.
A senior level Claims manager will also be responsible for mentoring and guiding other claims managers within the department. Effective communication, especially with leaders throughout the system will be vital for success in the role.
Workplace Category: Flex-Virtual
Remote work for this position may be approved based on policy and business consideration.
Essential Functions
-
Administers and coordinates integrated claims management involving Workers Compensation (WC) program, Short Term Disability (STD), Long Term Disability (LTD), Family Medical Leave Act (FMLA), American’s with Disability Act (ADA), Military and Personal Leaves in accordance with the respective organization’s Plan Documents, policies and applicable laws that govern them. Coordinates integrated claims management with WC Third Party Administrator, STD and LTD vendors to provide timely and accurate customer service. Investigates and follows up on abnormal activities with a claim. May represent Spectrum Health in workers’ compensation hearings.
-
Serves as a liaison between treatment providers, occupational health, ergonomic consultants, nurse case managers, TPA’s, vendors, legal counsel, staff, management, generalist and other HR departments to protect the rights of staff and reduce liability exposure of the organization. Communicates with providers of medical treatment regarding diagnosis and the length of disability with utilization of duration control guidelines as benchmarks.
-
Collaborates, educates, advises, and maintains positive relationships between client groups (management and generalists of all entities) and various areas of human resources by serving as a liaison to procure specialty services (leave and ADA administration) such as notification of employees rights and reviewing of requests for leaves/accommodations while ensuring equitable treatment of employees. Identifies new or existing management employees who are in need of information/consultation regarding leaves and provides information accordingly. Determines when to/and coordinates consultation with legal counsel so as to best advise on matters relating to HR standards and other regulatory compliance requirements.
-
Facilitates effective communication between management and employees regarding leave and ADA issues to promote employee morale and maintain an environment conducive to achieving reduced costs and increased productivity within the legal framework provided to the organization via the laws and policies that govern leaves.
-
Calculate and code hours owed into the payroll system. Answer customer questions and concerns regarding disability pay. Provides appropriate documentation into the IDM Claims management computer data base and the hard copy files via department standards.
-
Manages restricted work program within the organization for disabled workers. Oversees staff that are placed in temporary placements in or outside of their home department to see that restrictions and schedules are adhered to by the staff member and management.
-
Maintains up to date knowledge of the laws and pertinent legal decisions pertaining to the administration of leaves.
Qualifications
-
Required High School Diploma or equivalent
-
Preferred Associate's Degree Human Resources or Health Management
-
5 years of relevant experience Workers Compensation, FMLA/STD experience, computer experience, including Claims Management software, insurance background/experience, ADA, retirement plan administration, or benefits experience Required
-
Prior leadership experience preferred
Physical Demands
- Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
- Waist to Waist > 5 lbs: Seldom up to 10 lbs
- Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
- Waist to Overhead > 5 lbs: Seldom up to 10 lbs
- Bilateral Carry > 5 lbs: Seldom up to 10 lbs
- Unilateral Carry > 5 lbs: Seldom up to 10 lbs
- Pushing Force > 5 lbs: Seldom up to 20 lbs
- Pulling Force > 5 lbs: Seldom up to 15 lbs
- Sitting: Frequently
- Standing: Occasionally
- Walking: Occasionally
- Forward Bend - Standing: Seldom
- Forward Bend - Sitting: Occasionally
- Trunk Rotation - Standing: Seldom
- Trunk Rotation - Sitting: Occasionally
- Squat: Seldom
- Stair Climbing: Seldom
- Reach - Above Shoulder: Seldom
- Reach - at Shoulder or Below: Seldom
- Handling: Occasionally
- Forceful Grip > 5 lbs: Seldom
- Forceful Pinch > 2 lbs: Seldom
- Finger/Hand Dexterity: Frequently
- Visual Acuity ¹
[None = No; Seldom = Yes]: Seldom
Primary Location
SITE - Bridgewater Place - 333 Bridge St - Grand Rapids
Department Name
Human Resources People Solution - Integrated Disability Management
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8 a.m. to 5 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.
Spectrum Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws.
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws.
jjbodyshop.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, jjbodyshop.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, jjbodyshop.com is the ideal place to find your next job.