Matrix Absence Management
  • 07-Nov-2018 to 06-Jan-2019 (MST)
  • Workers Compensation
  • Austin, TX, USA
  • DOE
  • Salary
  • Full Time

Full Benefit Package


Matrix Absence Management is one of the top Third Party Administrators (TPA) supporting clients in absence management (FMLA/Disability/Workers' Compensation). We partner with our clients Human Resources department to manage Workers' Compensation, Disability and/or Leave of absences until the claim is resolved or the employee returns to work.  Our highly customer centric approach is to try and duplicate the culture of our clients to make the experience seamless for employees.  Our mobile app technology provides ease of use to our client and employee in reporting claim information.

Matrix Absence Management offers a full benefit package- Medical, Dental & Vision, including 401K match. Matrix is a friendly and pleasant office environment; offering flexible schedules M-F.

 

Position Summary:

Investigates, evaluates, and resolves non-disabling medical claims with limited complexity. Includes the investigation, evaluation and determination of coverage, compensability and responsibility and the setting of proper reserves.

 

Duties and Responsibilities: 

  • Processes claims consistent with clients' and corporate policies, procedures and "Best Practices" and in accordance with any statutory, regulatory and ethics requirements.
  • Exercise proper judgment and decision making skills to analyze claim exposure, determine a proper plan of action to appropriately mitigate and settle/close the claim.
  • Interacts with various parties involved in the claims process.
  • Interacts with Injured workers, client contacts and attending Physician(s) to ensure awareness and understanding of the Workers' Compensation process, requirements and entitlements.
  • Interacts with Disability and Leave Examiners' for the coordination of non occupational benefits.
  • Prepare and issue notices in accordance with mandated requirements and regularly review and stay abreast of applicable laws, rules and regulations that may impact how claims are processed.
  • Establish and maintain proper reserving throughout the life of the claim.
  • Identify Subrogation potential and pursue the process for reimbursement.
  • Comply with carrier excess reporting and threshold requirements.
  • Coordinate medical treatment for injured workers and provide information to treating physician(s) regarding the employee's medical history, health issues and job requirements.
  • Full understanding of Medicare reporting requirements as they relate to a Workers' Compensation claim.
  • Facilitate early RTW through temporary transitional alternate or modified work.  
  • Manages all medical aspects of a claim file with a focus on RTW and end of treatment.
  • Refers appropriate files for task management assignments to approved vendors for medical management, special investigative needs, Conditional payments, etc. within assigned authority. Monitors status and quality of work performed.
  • Enters and maintains accurate information in the claims management computer system.
  • Able to clearly communicate concise action plans and present plans for moving the claim to resolution.
  • Meets with clients to discuss on-going claims or review open claim inventory.
  • Effectively controls expenses on all Workers' Compensation Claims.
  • All other duties as assigned.

 

Other Duties 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job.  Duties, responsibilities and activities may change at any time with or without notice.

 

Education, Qualifications and Experience: 

  • BA/BS degree from an accredited College or University or 3+ years of demonstrated industry experience.
  • 0 2 years Workers' Compensation Claims Administration experience required.
  • Appropriately licensed and/or certified in all States in which claims are being handled.
  • Experience working with self-Insured and/or insured clients.
  • Multi-Jurisdiction experience is a (+).
  • Bilingual Spanish is a (+)

Essential Physical/Cognitive Job Functions

  • Prompt and regular attendance at assigned job locations
  • Ability to work shifts exceeding 8 hours, 5 days per week
  • Ability to interact with employees of all levels and clients in an appropriate manner
  • Ability to concentrate and think strategically
  • Availability onsite to confer with staff members with whom the incumbent must interact on a daily basis
  • Ability to proficiently use a personal computer for tasks such as email and preparing reports using software
  • Ability to review and analyze data and information.
  • Ability to complete, or oversee the completion of, assigned tasks/projects in a timely manner.

EEO Statement 

Matrix Absence Management is an equal opportunity employer applicants are considered for positions without discrimination on the basis of race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, veteran status or any other consideration made unlawful by applicable, federal state or local laws.

 

Matrix Absence Management
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