SUMMARY

The Workers Compensation Specialist is responsible for all aspects of workers’ compensation claims management with regards to: Workers’ Compensation, Leave of Absence (LOA), Family Medical Leave Act (FMLA), Americans with Disabilities Act Amendments Act (ADAAA) accommodation, injury counseling and transitional duty Return to Work (RTW) program. Actively manages claims in applicable states with workers’ compensation Third Party Administrators (TPA) and all databases. Responsible for ensuring compliance with all applicable state, local and federal regulations. Collaborates regularly with legal departments and human resources for related claims and administration in HR system. Appropriately partners with Manager to ensure processes, policies and procedures are amended as needed based upon internal or external changes or trends.

JOB DUTIES

• Triages all new workers’ compensation claims into appropriate claim management tracks to ensure timely delivery of applicable benefits. Initiates contact with injured Team Members; analyzes the situation and works with claims adjuster to create the best action plan on the claim. Explains Jo-Ann’s concerns and expectations, workers’ compensation benefits, TPA's role and Team Member’s rights and responsibilities.

• Manages multi-thousand-dollar claims independently. Monitors all workers' compensation claims and authorizes medical management strategies on individual claims. Obtains preliminary information on diagnoses, restrictions, treatment plans and full RTW release target date. Monitors all on-going medical treatment. Contacts treating physicians to obtain work restrictions and develops a strategy to return the Team Member to work as soon as practical. Obtains medical records as needed.

• Functions as a liaison between applicable Team Leaders, injured Team Member, and external vendors to ensure compliance and optimal claim handling, during the life of the claim. Responds timely to all incoming legal and medical correspondence on a daily basis. Understands, interprets and applies regulations, policies, procedures, contracts and labor management agreements.

• Monitors claims management by third party vendor to ensure cost effective outcomes. Identifies potential issues with the injury, treatment plan, claim adjuster, adjudication or litigation, and implement appropriate strategies. Redirects claim activity as appropriate and engages claim adjusters, defense attorneys and others in aggressive approaches to claims administration and closure.

• Manages transitional modified return to work program. Coordinates transitional duty assignments for Team Members returning to work with temporary work restrictions. Assists in the management of employees disabled from work due to an occupational injury with an objective to return to pre-injury status. Coordinates and facilitates review of employees with on-going restrictions.

• Using independent judgment, authorizes telephonic and/or field case management, vocational rehabilitation, investigation and other claims services, based on the circumstances.

• Provides required information and documentation to Team Members throughout the course of the claims and leave process including FMLA, LOA, and ADAAA. Conducts ADA interactive discussions and makes decisions regarding reasonable accommodations.

• Initiates claim settlements; analyzes all critical aspects of settlements and works with Manager to determine settlement feasibility and strategy. Manages claim reserves.

• Compiles, analyzes, and prepares comprehensive reports for effective management of claims. Generates and analyzes reports from TPA's systems and evaluates claims data; determines trends in Team Member accidents. Develops, maintains, and analyzes departmental dashboards. Evaluates ROI on medical management services and makes recommendations.

• Creates and promotes a safety culture by championing safety meetings and initiating safety plans in the stores, DC and SSC.

EDUCATION & EXPERIENCE

Education Minimum: Bachelors' Degree in Business, Human Resources or related field

Experience Minimum: 3-5 years of related experience

Experience Preferred: 5+ years of experience facilitating workers compensation claims.

WORKING CONDITIONS

• This role requires in-person attendance 4 days a week at the Store Support Center (SSC) located in Hudson, OH. Flexibility to work remotely when requested is determined by management and business needs.

• Sit or stand at a workstation for extended periods while maintaining focus and productivity.

• Move around an office space and between buildings on a large campus, including reaching for files, retail product, supplies, or equipment, as well as the ability to adapt to various workstation setups.

• Work standard business hours and extended hours as needed based on task and project demands.

• Utilization of all communication styles - written, verbal, electronic options.

• Lift and carry office supplies, documents, retail product or equipment weighing up to 20 pounds as needed for tasks such as organizing or setting up workstations.

KNOWLEDGE, SKILLS & ABILITIES

• Strong knowledge of medical and legal terminology

• Excellent written and oral communication skills

• Keen investigative skills

• Broad base of knowledge of state Workers' Compensation laws and guidelines, FMLA, ADA, OSHA guidelines and procedures and other relevant laws and regulations

• Knowledge of insurance claims adjusting

• Ability to perform mathematical calculations

• Skillset with Microsoft Office Products (Excel, Word, etc.)

This position will be located at:

5555 Darrow Road Hudson, OH 44236

Eligibility for benefits and incentives is dependent upon employment status. JOANN offers the following benefits and incentives to eligible Team Members:

• Medical, Dental and Vision benefit plans 
• Company-paid basic, Optional, and Dependent life insurance 
• Long-term disability and Company-paid Short-term disability 
• Paid Time Off and Sick Time  
• Tuition Reimbursement 
• Team Member Discount

For more details on benefits and eligibility requirements, Click Here or visit https://joann.myben.site/

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