Cincinnati- Claims Specialist - PN

Job Title

Claims Specialist - PN:  (260001UJ)

Workers' Compensation

Cincinnati Claims Office 135 Merchant Street Springdale 45246

Primary

Location:

United States of America-OHIO-Hamilton County-Springdale

Full-time, 40 hours per week

Claims Examination

A Little

About Us:

With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.

Our Culture: BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums and learn about how different perspectives can improve leadership skills.

Our Vision:
To transform BWC into an agile organization driven by customer success.

Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.

Our Core Values:
One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.

BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

• Manages a caseload of Workers’ Compensation claims: communicates, coordinates & collaborates with internal & external stakeholders (e.g., Disability Management Coordinator, Medical Service Specialist, Managed Care Organization, Employer Management team, Safety & Hygiene, injured workers, employers, Third Party Administrators & rehabilitation personnel) in order to set return to work expectations.
• Performs initial/subsequent claims investigation & determination within prescribed time frames: contacts parties involved in claim process; completes investigation during initial claim development to determine information pertinent to management of claim.
• Process various types of compensation (e.g., Temporary Total Compensation, Wage Loss, Permanent Partial and Percentage of Permanent Partial, Living Maintenance, Lump Sum Advancement requests); addresses subsequent requests by parties to claim via due process notification, investigation, BWC orders & referrals to the Industrial Commission (IC) of Ohio.
• Evaluates information & issues orders, makes claim allowance decisions in regard to Workers' Compensation law & policy, develops, implements, customer care plan on all eligible claims through collaboration with MCOs.
• Responds to customer inquiries.
• Follows Ohio Revised Code and BWC policies and procedures.
• Communicates with legal representatives, employers, claimants, etc.

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11…