Workers' Compensation Representative in Boston, Massachusetts at Massachusetts Bay Transportation Authority

The Workers’ Compensation Claims Representative (WCCR) will be responsible for the claims management of MBTA employees’ industrial accident claims from receipt of the Employer’s First Report of Injury to the conclusion of the claim with the closing of the file. The WCCR will manage employees’ Lost Time and Medical Only claims. The WCCR will approve or deny claims in accordance with the Department’s operating procedures and within the laws, rules, and regulations of MGL Chapter 152.

• Proven ability to categorize claims as Lost Time or Medical Only and ensure that all lost time claims are reported in a timely manner to the Department of Industrial Accidents.
• Represent the MBTA at the Department of Industrial Accidents (DIA) in Conciliations and provide testimony at DIA Hearings.
• Claim Investigations: taking statements from employees, witnesses, and supervisors.
• Gather and review medical documentation from medical providers.
• Manage workers’ compensation recipient payroll.
• Proven experience with electronic claims management systems to manage claim information, documents, and medical records.
• Experience identifying third party subrogation claims.
• Schedule and write examination letters for independent medical exams.
• Review and approve employee medical bills for payment.
• Prepare cases for litigation for outside counsel.
• Meet with assigned Area supervisors to review employee cases for return-to-work options.
• Meet and communicate effectively both verbally and in writing with other MBTA employees from other departments i.e., Human Resources, Leave Management, Labor Relations, Occupational Health Clinic, Safety, Legal.
• Effectively identify injury type trends and causes and report the same to the Safety Department.
• Perform all other duties and projects that may be assigned.

• A high school diploma or equivalent (G.E.D.) from an accredited institution.
• Two (2) years’ experience in worker’s compensation claims management and investigation.
• Demonstrated knowledge and understanding of Massachusetts General Law (MGL) Chapter 152.
• Excellent verbal and written communication skills.
• Experience managing sensitive situations in a confidential and effective manner.
• Have the ability to work effectively with a diverse workforce.

• A nationally recognized certification, or statewide/professional certification in a related field substitutes for one (1) year of experience.

• A bachelor’s degree from an accredited institution in Labor Relations, Business, Health Care Administration, Risk Management, Human Resources, or related field.