Advisor - On-The-Job Injury

Advisor - On-The-Job Injury Memphis Shelby County Schools - 3.1 Memphis, TN Job Details Full-time $63,880.35 - $91,883.04 a year 1 day ago Qualifications Collaborate with healthcare professionals Liability determination OSHA (regulatory compliance area) Appeals Record keeping Report writing Medical claims processing Leave management Regulatory compliance in claims processing Filing Collaborating with government agencies Subrogation Compliance management implementation Data quality management Policy & process development Bachelor's degree Legislation Medical billing Insurance investigations Safety records management Claims documentation management Senior level Training 2 years Documentation review

Full Job Description Purpose and Scope:

This position will administer, coordinate, and oversee the MSCS District's OJI Program. Responsible for processing and documenting all OJI claims and ensuring compliance with relevant policies, procedures, and legislation. Serves as the liaison with external agencies and regulatory bodies in the administration of claims and in the care and disposition of claimants.

Essential Job Functions:

Investigates and evaluates employee accident reports by gathering data and compiling facts to include reviewing accidents reports, witness statements, medical documentation, and department investigation results when deciding on the approval or denial of a claim. Provides training for District employees on OJI benefits and responsibilities and assists departments in conducting OJI investigations and preparing accident reports, including interviewing of witnesses and the procurement of relevant documentation. Analyzes data to identify patterns of injury and to determine whether unsafe conditions contributed to the accident. Responsible for data integrity, efficiency, quality for OJI benefits transactions, and OSHA 300 and 300A recordkeeping and report submission; prepares and maintains a variety of reports, records, correspondence, and files related to OJIs. Collaborates with Safety Advisor regarding advisement to departments of trends in injuries and proper safety procedures that may result in reduction of injuries; provides department with information that will aid in reducing accidents and improve safety Collaborates with Risk Advisor regarding subrogation for OJIs involving third parties and follows MSCS established policies and procedures in maintaining files, processing claims and the reimbursement of expenses paid out by the MSCS District. Coordinates with the Benefits Department regarding OJI leave of absence, Payroll Department to ensure employee's employment status is coded correctly, and General Counsel regarding subrogation and the insurance company to ensure OJI claims are paid accurately and timely. Processes OJI billing and reimbursement for the MSCS District to ensure proper OJI benefits. Provides instructions to management on all OJI related topics such as work status, light duty restrictions and payroll coding; keeps track of return dates, all required paperwork and sends compliance notices. Fosters and maintains relationships with medical professionals and support agencies to monitor and assess the progress of rehabilitation efforts and to facilitate either return to work or appropriate alternative placement within the MSCS District. Provides job description and pertinent information to medical providers to assist in an accurate assessment of the employees' duties and responsibilities on the job. Stays abreast of industry's best practices, changes in governing regulations and/or laws and provides leadership recommendations regarding internal processes and policies to ensure continued compliance. Reviews and assists on updates to the OJI Policy with the Governmental Affairs and Compliance Manager; reviews and drafts the OJI Procedures and ensures the OJI Program is applied consistently. Assists the Appeals Committee Board by gathering information about OJI related claims and providing documentation needed during appeal hearings. Analyze liability which includes student and visitor claims, theft, and damage of school equipment, and assist with insurance claims. Assist with AED service and device replacements. Conduct and Complete District property inspections. Investigate AED incidents. Investigate auto accidents. Review certificate of insurance (COI) and additional insured endorsements. Performs other related duties as assigned or directed.

Minimum Qualifications:

Graduation from an accredited college or university with a Bachelor's degree plus four (4) years of related experience, OR an equivalent combination of education and/or experience totaling eight (8) years. (PROOF

OF EDUCATION, TRAINING, AND/OR EXPERIENCE IS REQUIRED

) .

Degree Equivalency Formula:

Bachelor's Degree= 4 years plus required years of experience. Master's Degree= 2 years plus required years of experience. Where Master's degrees are required, years for Bachelor's Degrees must be included.