Additional Information About the Role BJC Health has a remote opportunity for a Sr. Worker's Compensation Specialist to join the team. This position manages workers' compensation and employee injury cases from initial report through final resolution, overseeing the full lifecycle of each claim from investigation to settlement. Ideal candidates should be familiar with Missouri and Illinois works compensation regulations.
Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations.
Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit.
That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country. Preferred Qualifications Role Purpose 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. Responsibilities 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 al