Workers Compensation Jobs in Puerto Rico (NOW HIRING)

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GENERAL PURPOSE OF THE JOB

The Workers' Comp Specialist is responsible for handling and oversight of DaVita's Workers' Compensation claims and acts as a direct liaison between DaVita's management staff, teammates, claim adjusters, and defense counsel. Position directs claims resolution activities including claim reserve analysis and claim settlements.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.

• Evaluate claims to determine potential exposure; make recommendations concerning the value of the claim; oversee litigation and assist in the negotiation of settlements

  • Escalate issues as appropriate for prompt and effective resolution

• Proactively oversee the Worker's Compensation claims management activities in assigned territories and resolve problems of varying scope and complexity in accordance with state statutes

• Evaluate high exposure Workers' Compensation claims for settlement and appropriateness of established reserves

• Attend claims audits and reviews; ensure claims are postured for expedited resolution

• Provide daily assistance to DaVita's management staff, teammates, claims adjusters, insurers, and defense counsel by answering claims-related questions or concerns in the administration and management of claims, and other claims matters

• Facilitate and coordinate teammate return-to-work by working with DaVita management, claims adjusters, and nurse case managers.

• Analyze claims data to identify needed loss control interventions and assist with the development of appropriate loss prevention programs as requested

• Provide training and education to facilities on Workers' Compensation processes and procedures as needed or requested

• Coordinate the handling of Workers' Compensation subpoenas in an expeditious manner

• Provide reporting and analysis on key metrics related to assigned territory(ies), including analytics on projected and/or established medical provider networks

• Escalate exceptions, outliers, or circumstances that are out-of-norm to Corporate Claims Manager as they occur and seek guidance in resolutions

• Participate in meetings, presentations, and special projects, as necessary

• Other duties and responsibilities as assigned including but not limited to:

  • Attend team meetings, phone conferences, and training sessions

  • Know, understand, and follow teammate guidelines, employment policies, and department or company procedures

• Flexible schedule and ability to travel required

• Travel required: up to 10%

MINIMUM QUALIFICATIONS

(Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required)

• Bachelor's degree in related area highly preferred

• Workers' Compensation certification preferred; certification or experience in multiple jurisdictions preferred including but not limited to state mandated certificates such as WCCP, WCCA, etc.

• Minimum of three years' experience managing and/or handling Workers' Compensation claims required

• Intermediate computer skills and proficiency in MS Excel, Word, PowerPoint, and Outlook required

ESSENTIAL BEHAVIORS, SKILLS, AND ATTITUDES REQUIRED FOR SUCCESS IN THIS POSITION

• Commitment to DaVita's values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors in every day performance and interactions

• Demonstrated sound judgment and initiative in working within departmental and corporate guidelines, including the ability to maintain confidentiality of information

• Strong written, verbal, and interpersonal communications skills including ability to listen attentively and to communicate information clearly and effectively throughout all levels of the organization with audiences of varying degrees of familiarity with material

  • Demonstrated ability to work well with cross-functional groups

  • Demonstrated interpersonal, collaborative, and relationship-building skills; ability to interact positively with teammates at various levels across the company

  • Approachable and open

  • Demonstrated ability to communicate difficult or sensitive information tactfully

• Self-directed; able to function independently and as a member of a team and to foster a positive work environment

• Demonstrated strengths in organizational, attention-to-detail, follow-through, critical thinking, and innovative problem solving skills

• Strong time management skills; ability to manage multiple projects, deadlines and multiple priorities in a fast-paced, ever changing and evolving work environment with shifting time frames

• Strong understanding of business process with the ability to deliver requested output timely and accurately

• Strong analytical skills with the ability to seek out underlying assumptions through probing, questioning, and listening; ability to analyze information quickly and accurately with demonstrated ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives

Here is what you can expect when you join our Village:
A "Community first, Company second" culture based on Core Values that really matter.
Clinical outcomes consistently ranked above the national average.
Award-winning education and training across multiple career paths to help you reach your potential.
Performance-based rewards based on stellar individual and team contributions.
A comprehensive benefits package designed to enhance your health, your financial well-being and your future.
Dedication, above all, to caring for patients suffering from chronic kidney failure around the world. High school diploma or equivalent required
Minimum of three (3) years' healthcare reimbursement experience preferred ; experience with admissions, billing, and collections preferred
Demonstrated knowledge of insurance rules, regulations and Coordination of Benefits for federal, state, and managed care payors in multiple states preferred
Basic computer skills and proficiency in MS Word, Excel, and Outlook required
Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
Why wait? Explore a career with DaVita today.
Go to http://careers.davita.com to learn more or apply.

What We'll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace, backup child and elder care, maternity/paternity leave and more

• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

#LI-JS5

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.

This position will be open for a minimum of three days.

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits

Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.