Workers Compensation Claims Examiner Senior Lead at University of Wisconsin System
Madison, WI 53715
About the Job
The Universities of Wisconsin are a premier system of public higher education serving more than 164,000 students. Awarding nearly 37,000 degrees annually, the universities are Wisconsin’s talent pipeline, putting graduates in position to increase their earning power, contribute to their communities, and make Wisconsin a better place to live. Through a constellation of 13 universities statewide, the Universities of Wisconsin are a tremendous academic, cultural, and economic resource for Wisconsin, the nation, and the world.
The Universities of Wisconsin Administration assists in establishing policies, planning the programmatic financial and physical development of the Universities. UWSA supports the Universities in delivering transformative educational outcomes and research that expands the boundaries of knowledge. We work to extend the value of our universities beyond the boundaries of the campuses, seeking to enhance the quality of life for all in Wisconsin and beyond, in fulfillment of the Wisconsin Idea.
The mission of the Office of Risk Management is to provide a safe and healthful higher education environment for students, faculty, staff, and others utilizing UW System programs and facilities. The Office of Risk Management strives to meet this goal with:
- proactive loss prevention, health, safety, and environmental management
- quality property, liability, and worker’s compensation claims management
- protection of UW System assets
- risk assessments and mitigation planning
The Office of Risk Management efforts encompass developing and maintaining emergency management systems and responses, monitoring areas of high risk, providing guidance and expertise on worker’s compensation claims and workplace injuries, negotiating insurance policies on behalf of the UW System, and more.
POSITION SUMMARY
Under the supervision of the Risk Management Director in the University of Wisconsin Administration, this position manages an assigned portion of complex university employee worker’s compensation claims.
MAJOR RESPONSIBILITIES
Responsibilities include the following key activities:
- Receive and investigate complex claims to approve, suspend, or deny claims within the statutory guidelines laid out by Wisconsin Stats. Chapter 102.
- Following compensability determination, issues timely worker’s compensation benefits and maintains appropriate case reserves.
- Interprets and evaluates medical reports to determine benefits.
- Handle confidential information relating to employee data and medical records
- Recommends appropriate use of third-party services such as private investigations, independent medical examinations, and case management services.
- Evaluates the potential for third party lawsuits and notifies all parties of the state’s subrogation interests.
- Assist campuses in the development of early return to work programs, striving to restore the injured worker to a pre-injury health status and gainful employment.
- Pays medical bills when appropriate; also authorizes payment of bills to bill review.
- Research worker’s compensation issues, reports findings, and assists in evaluation of reports, decisions, and results in relations to established goals.
- Recommends new approaches, policies, and procedures to effect continual improvements in efficiency of department and services performed.
- Assist in the training and mentoring of the worker’s compensation examiners.
MINIMUM QUALIFICATIONS
To be considered for this position, a candidate must have:
- 5 years of direct worker’s compensation claims experience, including the handling of indemnity and lost time claims.
- Experience with subrogation and litigation.
- Excellent written and verbal communication skills
- Proficient use of Microsoft Office Products
- Excellent customer service skills
- Ability to analyze difficult problems and make independent judgments
PREFERRED QUALIFICATIONS
Well qualified applicants will also have a substantial amount of experience in a combination of the following:
- 7 years of direct worker’s compensation claims experience.
COMMITMENT TO INCLUSIVE EXCELLENCE
Inclusive Excellence is a source of strength, creativity, and innovation for Universities of Wisconsin. We value the contributions of each person and respect the profound ways their identity, culture, background, experience, status, abilities, and opinion enrich the Universities of Wisconsin community. We commit ourselves to the pursuit of excellence in teaching and learning, research, scholarship, creative activity, community service, and diversity as inextricably linked goals.
Universities of Wisconsin fulfills its public mission by creating a welcoming and inclusive community for people from every background – people who serve the State of Wisconsin and the public good.
CONDITIONS OF EMPLOYMENT
This offer of employment is conditional pending the results of a criminal background check and a reference check process that includes questions regarding employee misconduct, sexual violence and sexual harassment. If you have prior work history within the past 7 years with Universities of Wisconsin, your personnel file will also be reviewed for employee misconduct. If the results are unacceptable, the offer will be withdrawn or, if you have started employment, your employment will be terminated.
The Universities of Wisconsin will not sponsor a work visa for this position at the time of hire or anytime during employment. All persons hired will be required to verify identity and eligibility to work in the United States and complete the required Employment Eligibility Form I-9 upon hire.
WORK LOCATION
Limited telecommuting or hybrid work options may be available and may be considered only after a satisfactory probationary period. Preference will be given to candidates that reside within the state of Wisconsin. The office is located at 780 Regent Street, Suite 105, Madison, Wisconsin 53715. Telecommuting agreements are subject to change at any time.
COMPENSATION AND BENEFITS
The WC Claims Examiner Senior – Lead (working title), Workers’ Compensation Administrator (Inst) (official title) is a full-time, salaried (exempt) academic staff appointment. Well-qualified candidates can expect a starting annual salary within the range of $70,000 – $80,000 annually commensurate with the candidate’s education, related experience, and qualifications.
The Universities of Wisconsin employees receive an excellent benefits package. To learn more about the benefits package, review the Universities of Wisconsin Employee Benefits Quick Guide (FA/AS/LI). Use the Health & Retirement Contributions Estimator to calculate the estimated value of your compensation and benefits.
APPLICATION INSTRUCTIONS
To ensure full consideration, please submit application materials as soon as possible. Applicant screening will begin immediately and be ongoing through Sunday, February 2, 2025. However, applications may be accepted until the position has been filled.
Visit UWSA Applicant Portal to submit your materials online and select the appropriate applicant portal, either External Applicants or Internal Applicants and click on the position title that you want to apply for. To receive full consideration, interested applicants are required to apply online and provide materials listed below in pdf format:
- Resume
- Cover letter addressing your experience and education as it applies to all minimum and preferred qualifications
Failing to submit the required application documents may disqualify your application.