WORKERS' COMP COMPLIANCE SPECIALIST 1 - 71914

Executive Service

Who we are and what we do:

The Tennessee Bureau of Workers' Compensation is the regulatory agency over the workers' compensation system in Tennessee. Employers who are subject to the Workers' Compensation Law, insurers, and medical providers are regulated by the Bureau. We work with employers, injured workers, and claims professionals to educate the public about workers' compensation benefits and resolve workers' compensation benefit disputes.

How you make a difference in this role:

In this role, you may investigate compliance issues with the Workers' Compensation Law by participants in the state's workers' compensation system. This investigation process could include reviewing and gathering pertinent records, participating in the legal process, working on settling or collecting penalty assessments for non-compliance, and other related tasks.

Job Overview:

Under general supervision, is responsible for investigating workers' compensation compliance cases of average difficulty; and performs related work as required. An employee in this class investigates referrals and other inquiries to determine compliance with Workers' Compensation Law. Interviews parties for clarification of workers' compensation compliance issues and gathers pertinent records and obtains other legal documents for purpose of investigation. This class differs from the Workers' Compensation Compliance Specialist 2 in that an incumbent of the latter may provide training to persons in the Workers' Compensation Specialist 1 class.

Key Responsibilities:

1. Conduct Investigations and Gathering Information: Investigates referrals and complaint related to Workers' Compensation non-compliance by interviewing parties, gathering legal documents, and may conduct onsite inspections to collect relevant facts.
2. Evaluation Compliance and Legal Standards: Assesses records and other materials to determine compliance with Workers' Compensation Law and may develop investigative plans or summarize findings in formal reports for leadership.
3. Conflict Resolution and Enforcement: May negotiate and collect penalties for non-compliance, and refer or close cases based on investigative findings, all under the direction of program leadership.
4. Administrative Tasks and Documentation: Performs electronic research, prepares investigative documentation, maintains accurate case files, and ensures proper record keeping for potential legal or administrative action.
5. Communication with Internal and External Stakeholders: Maintains contact with parties, and others, if necessary, through multiple communication channels, provides required forms, answers inquiries, and may participate in legal proceedings.
6. Training, Mentoring, and Education: Educates parties and/or external stakeholders on compliance laws and procedures, and mentors co-workers on investigative techniques and Workers' Compensation compliance best practices.
7. Planning and Organizing Investigations: Creates and executes investigation plans, ensures adherence to statutory deadlines, and prioritizes cases based on urgency and legal requirements.
8. Reporting, Coordination, and Data Analysis: Prepares and submits internal reports, coordinates with other departments and agencies as necessary, and analyzes incoming referrals to determine whether further investigation or case closure is appropriate.

Minimum Qualifications:

Education and Experience: Graduation from an accredited college or university with a bachelor's degree; and experience equivalent to two years of full-time work in one or a combination of the following: administering insurance or workers' compensation claims; or conducting investigations. Additional qualifying experience as described above may substitute for the required education to a maximum of four years. Graduate course work credit received from an accredited college or university with emphasis in business administration and management, criminal justice, labor/industrial relations, health care administration, insurance and risk management, law, paralegal studies, political science, and/or public administration may substitute for the required experience on a month-for-month basis to a maximum of two years (e.g., 36 quarter hours in one or a combination of the above listed fields may substitute for one year of the required experience with the exception of law, in which 28 quarter hours may substitute for one year of the required experience).

OR

Graduation from an accredited college or university with a master's degree with emphasis in business administration and management, criminal justice, labor/industrial relations, health care administration, insurance and risk management, political science, and/or public administration.

Necessary Special Qualifications: Applicants for this class must:

1. Be eligible to become a notary public;
2. May require a valid motor vehicle operator's license for employment.

Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that person's race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws.