Compete BWC forms according to the rules and regulation, schedule patients appointments, phone calls, verify the appropriate information on self insured workers compensation claims, all other request from the doctors.

Determine the compensability of the claim, 3 point contact with location, claimant, & the provider, recorded statement with the claimant. Calculate the wages, pre-pared file for hearing, set claims for IME, reviewed medical treatment, answered phones, paid compensation, computer operations, referred claim files for telephonic or field case management, pre-pare managed files for internal & external audits, directed files to legal counsel for an appeal on the orders, live & well checks, surveillance, evaluated claims for settlement, set reserves on medical managed & lost files, seek approval from Medicare & Medicaid.

Process C-9’s according to ODG and Miller, 3 point contact with the parties on the new claim. And follow calls to the IW advising of the C-9’s status. Pro-actively contact the medical provider for the C-9’s on the requested treatment noted in the medical notes. 30 day work stability calls on medical only claims and 60 day work stability call on lost time claims. Contact the employer on light duty release with restrictions.

Compare Patients names, date of birth and ICD codes on medical charts, excel sheet. Corrections on the computer with incorrect data.

Update the OSHA 300 log set up the new claim. Review the claim for the mechanism of the injury. Fax medical & first report of injury to the 3rd party administrator. Discuss the plan of action on the claims with the adjuster. Filing. Answered employees questions & concerns in regards to their claim. Review & follow up on paper work to the BWC to ensure they are compliant with the state. Separated all incoming correspondence & send to the proper department. Follow up calls made to the doctors office to ensure the claimant had medical treatment & to get the medical treatment plan along with the medical records. Follow up with the supervisors to get the proper paperwork for the claim.

Investigate workers compensation claims, File workers compensation & liability claims with the 3rd party administrator. Maintained workers compensation claim files, Safety meetings with supervisors to review the claims & the core cause of accidents. Monthly claims review with the management team to discuss the open claims on review & reserves set on claims. Daily contact with 3rd party administrator on open claims, review & revise light duty jobs & implement changes for current light duty jobs as needed, Report to the Vice President/General Manager on a daily basis with the current status of all operations, weekly reporting to the Vice President/General Manager on the current bench mark reporting, Walk through all warehouses to review for safety hazards, followed routes to ensure drivers were working in a safe manner, Implement preferred work methods, Update all OHSA reports.

Decided claims adjuster for Ohio claims. Determine the compensability of the claim, 3 point contact with location, claimant, & the provider, recorded statement with the claimant. Calculate the wages, pre-pared file for hearing, set claims for IME, reviewed medical treatment, answered phones, paid compensation, computer operations, referred claim files for telephonic or field case management, pre-pare managed files for internal & external audits, directed files to legal counsel for an appeal on the orders, live & well checks, surveillance, evaluated claims for settlement, set reserves on medical managed & lost files, seek approval from Medicare & Medicaid.

Process all claims for Ohio and West Virginia. Determine the compensability of the claims, 3 point contact with location, claimant, & the provider, recorded statement with the claimant. Calculate the wages, pre-pared file for hearing, set claim for IME, reviewed medical treatment, answered phone, paid compensation, computer operations, referred claim files for telephonic or field case management, pre-pare managed files for internal & external audits, directing files to legal counsel for an appeal on orders. live & well check, surveillance, evaluate claims for settlement, set reserves on medical managed & lost time files, seek approval from Medicare & Medicaid.

filed appeals orders & motions, paid compensation, set claimants up for IME, pre-pared file for hearing, requested medical notes from provider, filed claim with the BWC, answered phone, computer operations, reviewed medical treatment, determine the compensability of the claim, calculate wages, pre-pared file for internal & external audits, set reserves on all claims, pre-pare & referred files to re-insurance, client meeting.