Investigates claims to determine an injured worker’s entitlement to Workers’ Compensation benefits; Administers indemnity and medical benefits for valid Workers’ Compensation claims; Manages a caseload of claims from inception to closing or settlement; Completes 3-point contact on new claims within 48 hours in order to obtain information necessary to make a compensability decision on the claim; Establishes appropriate reserve levels based on financial exposure and updates reserves upon receipt of new information; Directs payment of medical and indemnity benefits and awards; Issue state-mandated benefit notices within the required time frames; Responding to questions and requests from policyholders, claimants, and providers.
Develops and oversees citywide wellness program, implementation and management of on-site clinic, analysis of current trends, implementation of new strategies, creates data analysis of benefit plan performance, conducts meetings, and represents the City to third-party administrators, vendors, department representatives, elected officials, and employees.