General Description:
The Worker’s Compensation Coordinator will ensure timely processing and monitoring of workers’ compensation and Heart and Lung claims managed by the City of Scranton third party claims administrator, evaluate accident reports to determine accuracy and completeness and to ensure adequate investigation, ensure that the city is in compliance with applicable laws and regulations, and provide training and guidance to claims coordinators in all departments. This position serves as the primary contact with the Commonwealth of Pennsylvania Department of Labor and Industry Self Insurance Division and will be responsible for all report filing requirements.
Essential Job Functions:
- Monitor the performances of the third party administrator and managed care provider to help ensure the timeliness and thoroughness of the process;
- Assist the third party claims administrator to evaluate loss reports, ensuring the timely processing of medical bills and temporary total disability benefits;
- Compile facts and review data regarding accident reports and filed cases;
- Work with legal staff to review medical reports, witness statements, department investigation results, and other documentation;
- Review documentation with the third party administrator to determine whether medical bills and temporary total disability benefits should be continued;
- Assist in the review and authorization of medical bills and temporary total disability benefits upon receipt of proper documentation;
- Advise and/or assist departments in conducting investigations of accident reports, including the procurement of relevant documentation;
- Assure that the City of Scranton maintains a high compliance level with Workers Compensation guidelines;
- Serve as the primary point of contact with legal staff, third party administrators, and the Department of Labor and Industry;
- Review accident reports to identify patterns of injury and to determine whether unsafe conditions contributed to the accident;
- Advise departments of trends in injuries and proper safety procedures that may result in reduction of injuries;
- Provide department with information that will aid in reducing accidents and improve safety;
- Facilitate accident prevention and risk management activities in compliance with OSHA regulations or guidelines, to include the following topics:
- OSHA Bloodborne Pathogens Standard
- Tuberculosis (PPD) testing
- Ergonomics awareness and evaluations
- Workplace violence
- Pre-placement physical examinations
- Help plan and coordinate the implementation of the above activities in conjunction with Department of Labor and Industry guidelines and a variety of public and private sources, and assist legal staff by recommending and/or drafting new and revised program policy;
- Work with the Department of Labor and Industry to help develop and promote City of Scranton safety training programs and achieve certifications to complete such tasks as necessary;
- Participate as an advisor or member of safety committees;
- Resolve identified problems informally and/or through regularly scheduled meetings;
- Attend seminars, conducts research, and maintains liaison with individuals in the medical community and health care fields to keep abreast of current medical procedures and medications;
- Other duties as required.
Required Training, Experience, Knowledge, Skill, and Abilities
- Requires knowledge, skills, and mental development equivalent to the completion of four (4) years of college with courses in a related field;
- Working knowledge of the Workers’ Compensation Act and other applicable state/federal statutes and regulations;
- Working knowledge of medical terminology, body systems, and/or impairments and their disabling effects;
- Ability to evaluate all medical and time-loss claims information to make determinations regarding payment of temporary total disability benefits and medical bills;
- Good judgment in interpreting medical facts associated with compensation cases.
Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Worker’s Compensation/Risk Manager
Last modified: January 6, 2023
