Sr. Workers Compensation Specialist

Process all BJC workers' compensation claims using the latest technology to review, analyze and process complex cases within assigned authority limits.

This includes making automomous decisions within their authority regarding compensability, evaluating losses, coordinating medical treatment, within jurisdictional guidelines, negotiating settlements, and being subject matter experts to BJC.

• Continued Education in all legal changes in the workers’ compensation laws for jurisdictions being handled. Stay updated in changes and procedures in the medical treatment of work-related injuries both physical and mental. Must be familiar with legal and medical terminology along with legal required filing dates and procedures.
• Process workers’ compensation claims. Determine compensability, investigations, coordinate medical treatment, within jurisdictional guidelines, direct our outside attorney firms, negotiate settlements, assure cases are reserved for adequate financial exposure per state requirements. Participate in Arbitration, Mediations, and Trials to bring the cases to final resolution. Review medical and panels with Manager. Be a resource for Case Coordinators and Occupational Health.
• Serve as a subject matter expert. Provide Occupational Health department, BJC Leave/ADA, and BJC Corporate Legal support regarding any implication’s workers’ compensation may have in their areas. Develop training programs for BJC employees, Management and Occupational Health to better understand the rights and processes of workers’ compensation.
• Maintain adequate financial reserves on each claim and coordinate the legal activities associated with assigned cases. Establish adequate reserves on each file to support the probable outcome of the file based on the facts at the time of review within their authority. These are required to ensure that BJC can maintain their self-insured status within Missouri and Illinois. These financials are also used to develop BJC’s exposure for the actuarial review for the financial strength of BJC. Provide direction and oversite to the partnered law firms to bring timely and cost- effective resolutions, and assure the firms are working with in the established guideline within their authority levels. Request approval for all reserves and settlement authority above their authority. Attend Arbitration, Mediations, and Trials when needed.
• Report and coordinate with BJC’s Reinsurance carrier any claims meeting the reporting requirements. Send initial notice of specific cases per the policy when they occur and within the designated time requirements. Provide follow up and sequential reporting as needed.

• High School Diploma or GED

• 2-5 years

• No Experience

• Bachelor's Degree
• Business

• 5-10 years

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC

• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary .

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position.

It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

Equal Opportunity Employer