Sirius Technical Services, Inc.
Temporary Job Position

Job Number 000049WH
Job Title Claims Processor - Newport News, VA
Location Portsmouth, VA
Description Workers Compensation Representative I Description/Comment: Investigates and reviews employee workers compensation claims reports to determine liability. Investigates accident and/or safety occurrences. Reviews safety reports and statistics. Negotiates, prepares, evaluates, and settles cases with employee/claimant, attorney, insurance carriers, and providers to minimize claims settlements. May settle claims. 0 years with Bachelors Special Requirements • Counsels with workers' compensation claimants to ensure their understanding of benefit entitlement, the company's return to work policies and the claimant's responsibility to NNS, etc. Maintains periodic and appropriate contact with claimants during absence from work; monitors claimants progress and appropriateness of length of absence to expedite the claimants return to work and/or claim settlement. • Actively adjusts claims based on obtained information. Initiates the required reporting of all employee work-related injuries and illnesses. Analyzes accident report forms filed by the employee with the NNS Clinic, determines applicability under state or federal venue (Longshoremen's and Harbor Workers' Compensation Act, Virginia Workers’ Compensation Act), and oversees the preparation and filing of legally required reports within stringent time constraints. • Determines and approves the payment of medical expenses for work-related injuries and illnesses. Determines eligibility and calculates workers' compensation benefits for temporary-partial, permanent-partial, temporary-total, permanent-total, death, and other related benefits. Utilizes employees’ earnings data, mathematical formulas, and interest rates to determine benefits payable under the various acts. Ensures that accurate payments are made within stringent legal time constraints. • Researches, prepares, and presents company position at conferences involving workers' compensation claim disputes filed by an employee or their attorney, with the U.S. Department of Labor. Investigates and analyzes each case, formulates company position, and presents same during conference. Monitors and utilizes information gathered in the prosecution of fraudulent claims. The incumbent also makes recommendations on whether an appeal should be filed to seek the overturn of compensation awards. Completes review of attorney fee petitions and prepares responses to the jurisdictional authority. • Reviews/monitors all medical progress notes. Coordinates, analyzes and communicates information to keep cognizant departments, outside agencies, treating and staff physicians, outside health care providers and the utilization of the return-to-work program. • Must be able to drive personal vehicle to meetings and conferences. This position prefers a B.S. in Insurance, Business Administration or Finance, or the equivalent, plus 0 to 2 years experience in workers' compensation. Must have sound analytical abilities and excellent communication skills both oral and written. Must be proficient with computers. Must work independently, well under stringent legal time constraints, the ability to multi-task, and have strong time management skills. Must have fundamental concepts, practices and procedures of case management. General knowledge of shipyard operations and layout, as well as medical and legal terminology and practices and procedures are preferable.

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Sirius Technical Services, Inc. is an equal opportunity employer

Last Update: December 8, 2016