Claims Coordinator Orientation Information
KEY RESPONSIBILITIES OF A CLAIMS COORDINATOR:
- A District Claims Coordinator acts as the liaison between certain District staff (as determined by District policy) and CCCSIG to ensure an immediate and direct line of communication for the administration of Workers' Compensation benefits and associated claims cost containment activities.
- Assists with district-wide communications for telephonic claims reporting through Company Nurse for new Supervisors (training and materials) and Employees (materials)
- Assists with the reporting of new claims to Company Nurse in lieu of a supervisor or manager
- Assists in providing payroll, personnel and general claims information to the CCCSIG Claims staff assigned to the claim
- Receives and provides medical information to CCCSIG Claims staff, as available to them
- Working in conjunction with CCCSIG Return to Work Specialist, is responsible for placing employees into Temporary Work Assignments (TWA) or Modified Duty within three days of the injury, when appropriate
- Assists CCCSIG in obtaining signatures/authorization of District HR Managers on required forms pertaining to permanent modified/alternate work assignments
- Participates in the district claims review meetings and in many cases reports results to designated district staff
- Ensures CCCSIG has current district information including contact and site data to pass on to Company Nurse
- Receives/orders updated workers' compensation materials (medical panels, pamphlets, posters, etc.) and distributes, as appropriate
- Attends countywide Claims Coordinator meetings and training sessions at CCCSIG, usually once a year
In most districts, Claims Coordinators have other duties associated with the HR function, such as payroll or benefits.
CLAIMS COORDINATOR ORIENTATION MATERIALS
Overview of Programs:
Company Nurse
How Company Nurse Works
The Role of our Triage Nurses
Company Nurse Online Training
District Medical Panel listing
Pharmacy Benefit Management Program
Return-to-Work Program
Memo from Executive Director
Benefits of Temporary Work Assignments in ERTW
RTW Guidelines
RTW Process for Claims Coordinator
RTW Process for Injured Employee
ERTW Flow Chart
Temporary Work Agreement
Pre-Designated Temporary Work Assignments
Work Status Fax
RTW Process for Injured Employees Pamphlet
Utilization Review & ACOEM
Description of Employee's Job Duties Form 10133.33
Utilization Review – FAQ's answered by the State
Overview of Self-Administration
Red Flags for Claims Investigation
CCCSIG Preferred Provider List
Statement of Personal Physician Designation & Pre-Designated Physician Form
Statement of Personal Chiropractor or Personal Acupuncturist
Average Weekly Wage Flyer
WC Frequently Asked Questions
WC Glossary of Terms
Information Sources
CCCSIG Facts About Workers' Compensation
Medical Panel Posters
Sample Monthly Trend Report
Time of Hire Pamphlet
For questions please contact Michael Clark, Claims Manager or Karen Hurd, Claims Supervisor. |
