Risk Management Analyst – Worker's Compensation InsuranceBookmark This
Texas Children's Hospital
Job Title: Risk Management Analyst - Worker's Compensation Insurance Job ID: 127886 Location: Medical Center, Houston, TX Full/Part Time: Full-Time Regular/Temporary: Regular Shift: 8AM - 5PM
Salary Grade: 09 Texas Children's Health Plan was founded in 1996 by Texas Children's Hospital. Since 1996, families in Houston and surrounding areas have counted on Texas Children's Health Plan for affordable and dependable health coverage.
Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. It offers a primary-care network, specialists and a large hospital network. Texas Children's Health Plan also offers great services to pregnant women and adults.
At Texas Children's Health Plan, our staff and network of doctors, hospitals and providers are committed to providing excellent service and quality care to adults and children of all ages.
No third party considerations will be accepted at this time. Vendors please do not call HR directly to solicit. PURPOSE:
To provide direction for the Hospital¿s Workers¿ Compensation claims issues, including processing of claims, maintaining liaison with insurance carriers, maintaining files and databases of relevant data. Also, provide direction for the Hospital¿s Automobile/Garagekeepers claims issues, including processing of claims, maintaining liaison with insurance carriers, maintaining files and databases of relevant data. Other lines of insurance responsibility with the same processes are Foreign Liability, Non-Owned Aviation Hull Liability, Property Insurance, Travel Accident insurance and other lines as needed. Develops statistical and qualitative Risk Management reports and prepares data presentations relevant to the assigned lines of coverage.
1. Manages the Workers¿ Compensation Program
- Communicates with various department leaders within Texas Children¿s to obtain the required data for workers¿ compensation insurance renewals. Compiles and assembles data and prepares the application for the Texas Children¿s insurance broker. Ensures that all pertinent data is reported accurately and responds to surveys yearly.
- Compiles data provided by Payroll, Human Resources and Employee Health to prepare annual OSHA postings and respond to yearly surveys.
- Prepares and provides workers¿ compensation benefits packets with explanation of claims process to employee
2. Manages the Automobile/Garagekeepers Insurance Program
- Communicates with various department leaders within Texas Children¿s to obtain the required data for automobile/garagekeepers insurance renewals. Compiles and assembles data and prepares applications for the Texas Children¿s insurance broker. Ensures that all pertinent data is reported accurately and responds to surveys yearly.
- Prepares and provides auto insurance/claims packets with explanation of claims process to employee.
- Prepares and provides insurance company with appropriate documentation when claims are filed
3. Functions as the department¿s Liaison and Communicates/Collaborates with Insurance Broker, Insurance Carrier, Managers, Employees, Payroll and Employee Health.
- Completes annual renewal applications by preparing materials necessary for renewal of policies according to deadlines and responds to surveys prior to renewal/due date.
- Reports injury/auto/property claims to insurance carrier upon receipt of incident report.
- Manages the auto claim process to ensure repairs/property damage is completed timely
4. Provides insurance information to the state and outside agencies.
- Prepares and provides insurance information to the state and outside agencies according to deadlines established by the Division of Workers¿ Compensation, Occupational Safety and Health Administration (OSHA), Bureau of Labor Statistics and in compliance with state insurance reporting requirements.
5. Maintains safety management statistics and files.
- Maintains safety management statistics and files daily in compliance with the Joint Commission (JC) and state and federal agencies. This involves the use of electronic data methods and references to the laws, rules and regulations of external agencies.
- Ensures maximum confidentiality of this information to ensure necessary confidentiality required by law as measured by no breaches of confidentialities, while maintaining access to such information.
6. Provides informational summaries to the appropriate parties
- Prepares and provides management with summaries of claim patterns and risk control on a quarterly basis and on legislative and regulatory changes as made.
- Prepares and provides management with summaries of auto claim patterns and risk control on a quarterly basis.
7. Facilitate the implementation and technical support of browser-based software utilized for Risk Management and Safety Management.
- Supports the implementation, security and training of system-wide software to the hospital¿s internal users.
- Serves as a department-based technical liaison to Information Services for addressing issues/problems with software systems.
- Liaison with Information Services in facilitating installation and upgrades of new or existing software programs for the three departments.
8. Performs other essential functions related to insurance, risk and workforce issues.
- Prepares renewals for Foreign Liability, Non-Owned Aviation Hull Liability, Property Insurance, and Travel Accident Insurance policies and other lines as necessary.
- Prepares and completes requisitions for payment of insurance lines for Workers¿ Compensation, Automobile/Garagekeepers insurance, Foreign Liability, Non-Owned Aviation Hull Liability, Property Insurance, and Travel Accident Insurance.
- Participates in surveillance rounds to collect staff knowledge on various issues related to workforce risks and/or insurances. KNOWLEDGE:
Required for completely satisfactory performance in this job is knowledge of risk management functions and Workers¿ Compensation laws.
Required for completely satisfactory performance in this job is the ability to competently utilize multiple computer software for database management, analyze risk data, keep sensitive information confidential and effective communications skills with all levels of management.
FORMAL EDUCATION AND EXPERIENCE:
The formal education and/or experience required for completely satisfactory performance in this job is as follows:
¿ Bachelors degree
¿ Training and/or experience in Workers¿ Compensation Insurance claims processing familiarity with hospital insurance requirements and experience with loss control