Occupational Claims Coordinator
Location: Scarborough, ME or Salisbury, NC
This is the entry level Workers’ Compensation (WC) Claims Adjuster position through which all claims are triaged. In addition, a significant volume of cases remain with this individual until closure. Caseload claim functions are expected to be performed independently. This position also plays a key supporting role within the department for assigned jurisdictional teams, which entails heavy teamwork. A certain amount of specific administrative functions are performed daily depending on the needs of the jurisdictional and administrative teams. This position is the initial and ongoing portal into the Workers’ Compensation Department for other inquiries as well.
- At least 1-2 years of WC experience or related field.
- License preferred or ability to obtain and maintain state adjusting licensing where required by law.
- Must be capable of working independently.
- Self-directed work style that continues to seek quality improvements
- Ability to access and utilize information in a variety of systems.
- Reconciliation and problem resolution skills.
- Solid team work skills.
- Solid accounting skills for reconciliations, budget prep and payments.
- Solid interpersonal skills; solid decision-making.
- Process all initial claim intakes from daily retail, corporate, and warehouse entries.
- Triage the claim according to standards using the Incident Intake Form.
- Assumption or assignment of the claims depending on the results of the initial investigation.
- Manages an independent caseload utilizing the claim diary system and adhering to written Claim Standards (including proper reserving, approval of payments internally and with bill review, Rx, and other vendors) while maintaining clear file documentation.
- Initiate claim set up, state form preparation, and filing where appropriate. Prepare, authorize, and file various state forms in a timely manner, i.e. FROI, wage statements, etc.
- Handle a caseload of mostly medical only claims to resolution.
- Consult with Occupational Health Specialist when necessary to discuss medical treatment options, determine appropriate protocol, and ensure implementation for optimal results.
- Interact with retail, distribution and corporate management as needed, i.e., to facilitate appropriate claim assignment and/or supplement initial investigation to aid in caseload management.
- Assist in coordination of initial medical treatment, retrieval of medical records, referrals for diagnostic testing, medical specialists, and scheduling of therapy appointments prior to claim assignment.
- Maintain OSHA recordkeeping on their claims according to Claim Standards.
- Support state-specific reporting obligations, i.e. SI-4, Quarterly compliance, etc.
- Develop a working knowledge of banner policies and procedures, i.e. HR Policies and TWP.
- Filter and prioritize incoming phone inquiries, providing answers to claim questions and document the claim.
- Assist in WC legal and medical file preparation; including Lump Sum Settlement documents, IME/second opinions, discovery to opposing legal representation, etc.
- Complete special projects as requested by supervisors and adjusters.
Hannaford Bros. may have started as a fruit and vegetable stand in 1883, but it has expanded from its Maine roots to become an upscale...