Causation Specialist - Human Factors and Ergonomics, Region includes IL, Southern WI, Quad Cities

Job Description

This position requires travel throughout Illinois, Southern Wisconsin, Quad Cities area.

Prefer candidate to reside within Chicagoland area or southern WI.

REMOTE opportunity with a minimum of 50% day travel.

AF Group (or any Emergent Holdings) employees who cannot access our internal job board “Opportunity Marketplace”, please use your corporate email address to apply here.

A Claims Causation Specialist’s primary purpose is to ensure compensability decisions are made based on detailed investigation and facts surrounding the alleged mechanism of injury. This position will support cost containment programs, ergonomic, environmental disease, subrogation, catastrophic loss, and Return to Work (RTW) and alternative duty jobs to assist clients in returning injured workers in a timely manner.

A Causation Specialist is responsible for completing claim investigations to determine causation by evaluating injured worker’s duties related to ergonomic and occupational disease. This position will develop plans to evaluate potential repetitive motion injuries at work by reviewing claims related to repetitive strain injuries, repetitive motion injuries, repetitive motion disorder, cumulative trauma disorder, and occupational overuse syndrome. This position investigates Environmental Disease cases (inhalation issues, dermatitis injuries, and noise exposure claims).

• Conduct and coordinate loss investigations on all assigned claims to provide accurate facts for disposition, through on-site or via desk investigation.
• Analyze information and make determination to further investigate claims utilizing resources.
• Conduct job evaluation with clients to understand forensics and ergonomics of injured worker’s duties and responsibilities.
• Assist with cost containment programs and/or alternative duty jobs to assist clients in returning injured workers in a timely manner.
• Provide communication with the policy holder and internal Loss Control Representative for any safety hazards or potential ergonomic hazards identified.
• Assess various machinery and operations in evaluating and establishing negligence and 3 rd party liability for the subrogation process.
• Partnering with assigned claims investigation, responsible for assessing client’s industrial hygiene, including equipment maintenance and calibrations, pre-survey studies and research, completion of technical field evaluations and final reports.
• Provide accurate and timely information to all internal and external stakeholders to address claim status and other inquiries such as questions on subrogation recovery, reserve adequacy, and underwriting risks.
• Consistently monitors workflows to maximize efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
• Use independent judgment in all areas of responsibility, while considering department and division priorities.
• Prepare a work history biography and present technical reports or video at a claim court hearing.
• Conduct environmental disease investigations by analyzing data provided by a third party Certified Industrial Hygienist to compare the results to the ACGIH, OSHA and NIOSH recommendations.
• Travel by vehicle is required based on regional territory.
  
  

Qualifications

• Bachelor’s or Master’s degree in Occupational Safety and Health, Ergonomics, Environmental Disease/Industrial Hygiene or related field of safety and health. Would consider candidates with experience in healthcare, social services or manufacturing that have had formal education, licensed professionals, i.e. RN, LPN, PT, OT, Ergonomist, Industrial Hygienist, etc. An equivalent combination of education and experience may be considered in lieu of degree.
• Minimum two years relevant experience that provides the necessary skills, knowledge and abilities. Workers Compensation insurance experience preferred.
• Strong interpersonal and superior communication skills, including verbal and professional writing, report preparations and presentation skills.
• Expert knowledge of specific safety expertise, including but not limited to industrial hygiene, ergonomics, physical demands, or subrogation.
• Knowledge of insurance and extensive knowledge in occupational health, workers compensation case management, ergonomics, safety or other related subjects.
• Strong knowledge of laws, regulations, and compliance requirements related to insurance.
• Demonstrates technical knowledge of insurance administration, claims management, or relevant insurance expertise.
• Strong background in word processing, spreadsheets, video editing software, and graphics programs required with knowledge of Microsoft applications.
• Ability to analyze and interpret documents for accuracy to technical, legal and financial information.
• Ability to effectively exchange information clearly and concisely using professional and technical business grammar, present ideas, report facts and other information, and respond to questions as appropriate, both in oral and written communications.
• Ability to quickly make decisions and comprehend the consequences of various problem situations and take appropriate actions and/or refer problems for necessary decision making.
• Ability to organize and prioritize multiple assignments.
• Ability to work with minimal supervision.
• Working knowledge of using a force meter and noise dosimeter.
• Demonstrate strong customer service skills in interactions with claims staff and insureds.
  
  

AF Group (or any Emergent Holdings) employees who cannot access our internal job board “Opportunity Marketplace”, please use your corporate email address to apply here.

Working Conditions

Work is performed in a remote office or field setting with minimal hazards . However, it may be required to visit customer locations which may present some unusual hazards. Frequent travel is required with limited overnight stays. Field investigations include travel in a multi-state region. Must possess a valid driver’s license with a record that meets corporate standards. Work is required at various times of the day and sometimes weekend work may be required. Must be able to meet general physical requirements that would allow the causation specialist the ability to view and participate in account operations which may include climbing ladders and scaffolding, working in confined spaces and or other similar situations.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

“Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $70,400 and $117,800.”

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

#UWIC

About The Team

United Wisconsin Insurance Company