Clerk V (Workers' Compensation Specialist)

Apply now Job no: 522659
Work type: Staff Full Time
Campus: UMass Amherst
Department: Human Resources
Pay Grade: 15
Categories: Human Resources, Administrative & Office Support

About UMass Amherst

UMass Amherst, the Commonwealth's flagship campus, is a nationally ranked public research university offering a full range of undergraduate, graduate and professional degrees. The University sits on nearly 1,450-acres in the scenic Pioneer Valley of Western Massachusetts and offers a rich cultural environment in a bucolic setting close to major urban centers. In addition, the University is part of the Five Colleges (including Amherst College, Hampshire College, Mount Holyoke College, and Smith College), which adds to the intellectual energy of the region.


Job Summary

Minimize the University’s workers’ compensation (WC) liability by timely, accurately filing, and proactively managing, WC claims in collaboration with MA Human Resources Division Workers’ Compensation Unit (HRD WC) adjustors & legal counsel, UMass payroll & operations team, campus and UMass system Human Resources representatives.

Propose claims management and resolution/settlement strategies in collaboration with HRD WC. Act as claims manager and liaison between claimants, University departments, HRD WC, DIA and other agencies in matters concerning WC policies and procedures. Support and advise campus Human Resources representatives regarding WC.

Calculate reimbursable amounts in accordance with established procedures and explain WC process, time/labor and benefits to claimants. Generate WC statistics. Support and back up Leave & Sick Leave Bank administrator role. Assist at the Human Resources Information Center.


Essential Functions

  • File and manage WC claims including, but not limited to preparing for WC appeals, hearings, and authorizing Independent Medical Exams (IMEs); processing Notices of Injury and 101s timely to avoid late filing fines; preparing Personnel Action Forms and time/labor corrections. Consult with HR Payroll & Operations teams as needed. Compose correspondence to, and act as a liaison between, employees, departments, hospitals, doctors’ offices, attorneys and other state agencies in matters concerning WC procedures and policies.
  • Strategize with HRD claims/litigation representatives, employees and HR leave administrators to minimize WC absence with goal of returning employees to work or (if necessary) claims settlement.
    Exercise independent judgement in authorizing IMEs and surveillance as part of claims monitoring/resolution strategy. Represent the University at hearings when necessary.
  • Compute amounts to be reimbursed to University payroll accounts or the employee for sick leave, retirement & FICA. Explain calculation to claimants. Receive checks from claimants; create time/labor and wage corrections for processing by Payroll team.
    Compile WC statistical data, suggesting improvements and/or procedural changes to improve worker safety and reduce lost-time and University liability.
  • Conceive of and implement improvements to University WC, occupational injury management and return to work efforts. Compile information required for ordinary and accidental disability retirement applications. Compile data and respond to WC-related BLS questionnaires.
  • Update and maintain WC instruction manuals; cross-train benefits staff members.
  • Calculate non-work related automobile insurance buy-back payments for restoration of paid leave accruals; generate forms required for HR Payroll and Operations to process related time/labor corrections.
  • Act as liaison with department, employees and medical representatives (eg, representatives of UHS, hospitals and doctor’s offices) regarding WC-related payment requests and claims-related issues.
  • Support and back up Leaves Administration Specialist in administration of leaves & Sick Leave Banks.
  • Respond to customer inquiries (including in-person at the Employee Service Center) by fully understanding customer question/ request, determining urgency and following issue through to resolution (researching and resolving WC and general benefits problems) or referring inquiry for resolution. Answer general customer questions regarding employment and employee benefits, policies and procedures and provide appropriate forms/guidance; forward employees with specific or detailed questions to a subject specialist when necessary.
  • Assist with mailings and mail receipt/distribution. Other duties as required to support the operations of Human Resources and the University.
  • Establish and maintain a general knowledge of forms/processes related to University / Commonwealth insurances and benefits programs.


Other Functions

  • Performs other duties as assigned.


Minimum Qualifications (Knowledge, Skills, Abilities, Education, Experience, Certifications, Licensure)

  • Three (3) years of office experience. An Associate's degree or higher may be substituted for two (2) years of the required experience.
  • High school diploma or equivalent.
  • Experience with word processing and spreadsheet software. 
  • Administrative experience.
  • Attention to detail.
  • Ability to assess work priorities and meet deadlines.
  • Ability to collect statistical data, work with figures and compile statistical data.
  • Ability to successfully work independently and as a member of a team.
  • Ability to use a computer and familiarity with word processing and spreadsheet software.
  • Ability to interact with a wide variety of people. Dedication to providing superior customer service.
  • Ability to exercise independent judgement and creative problem solving skills (innovate).


Preferred Qualifications (Knowledge, Skills, Abilities, Education, Experience, Certifications, Licensure)

  • General knowledge of Human Resources policies and procedures.
  • General knowledge of employee benefits.
  • Knowledge of/experience with Human Resources or payroll functions preferred.
  • Experience with HRIS preferred.


Physical Demands/Working Conditions

Typical office environment.


Additional Details

Under the direct supervision of Benefits Supervisor, perform tasks in accordance with specified procedures and deadlines. Exercise independent judgement in performance of daily tasks. Proactively work with HRD audit & litigation representatives on claims administration, resolution strategies and settlement proposals. Work in collaboration with UMA HR representatives and HRD to minimize periods of WC absence and corresponding University liability. Bring exceptions to the attention of direct supervisor.


Work Schedule

Monday - Friday, 8:30 - 5:00pm.


Salary Information

Non-Unit Classified Grade 15.


Special Instructions to Applicants

Along with the application, please submit a resume. References will be checked at the finalist stage. Please be prepared to provide contact information for three (3) professional references.


UMass Amherst is committed to a policy of equal opportunity without regard to race, color, religion, caste, creed, sex, age, marital status, national origin, disability, political belief or affiliation, pregnancy and pregnancy-related condition(s), veteran status, sexual orientation, gender identity and expression, genetic information, natural and protective hairstyle and any other class of individuals protected from discrimination in employment, admission to and participation in academic programs, activities, and services, and the selection of vendors who provide services or products to the University. To fulfill that policy, UMass Amherst is further committed to a program of affirmative action to eliminate or mitigate artificial barriers and to increase opportunities for the recruitment and advancement of qualified minorities, women, persons with disabilities, and covered veterans. It is the policy of UMass Amherst to comply with the applicable federal and state statutes, rules, and regulations concerning equal opportunity and affirmative action.

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The University of Massachusetts is an Equal Opportunity/Affirmative Action, Title IX employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, ancestry, age over 40, protected veteran status, disability, sexual orientation, gender identity/expression, marital status, or other protected class.