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Claims coordinator responsibilities

Every organization large to small should have a designated "claims coordinator"--the point person responsible for reporting work injuries to SFM. The claims coordinator is a critical communications link between your organization and your SFM claims representative.

As claim coordinator, you're responsible to:

1. Complete the "Employer enrollment checklist" form and send it to CorVel

You should complete the checklist and mail it to CorVel soon after receiving your
Employer Kit
. Doing so shows that you have reviewed the materials and understand
your responsibilities as a claims coordinator.
2.

Train employees how to report work injuries

Your employees and supervisors need to know how, when and to whom to report work injuries.

Make sure all supervisors in your organization know to contact you if an injury occurs. Give them your contact information so they can notify you quickly following an injury.

SFM has partnered with CorVel Corporation to provide your organization with a certified medical case management program. CorVel medical case managers will ensure your employees receive appropriate medical care and assist them in returning to work following an injury.

If appropriate for your organization, train your supervisors how to complete the CorVel "Case Management Plan ID" cards and when to give them to employees following a workplace injury.

3.

Work with a chosen clinic

Establish a relationship with a clinic within CorVel's Preferred Provider Organization (PPO). Doing so helps reduce claims costs.

An employee who's been injured can choose to treat with his own provider. If a referral to a specialist is needed, CorVel's nurse case managers will help the employee treat with a provider in the PPO network.

4.

Report work injuries to SFM

Report an injury right away, ideally within 24 hours. The easiest, fastest and most efficient way to report is online through CompOnline®, SFM's password-protected website facility. Learn more about CompOnline.

Be as accurate and complete as possible. Stay in contact with your SFM claims representative. Be sure to let your claims representative know if the employee misses work or if information has changed after you reported the injury to SFM.

5.

Work with the injured employee

If the employee is missing work, call right away to see how he's doing. Ask about his status, the doctor's evaluation and how he is feeling.

Good communication is essential. Lack of it can cause fear or uncertainty that sometimes leads the injured employee to call a lawyer.

6.

Identify transitional jobs

It's your job to bring the employee back to work as soon as possible. This is a critical step in controlling the costs of the claim and its impact on your organization's work comp premium. Identifying lighter-duty, transitional jobs for the employee will bring him back sooner if he is unable to return to full duties.

Transitional jobs may include part-time work, existing jobs with different physical requirements, alternated job tasks or modified jobs. Think outside the box. Take suggestions from supervisors.

Your SFM claims representative and CorVel nurse case manager are good resources in helping to identify transitional jobs.

7.

Stay on track

Once the employee has returned to work, contact the employee and supervisor weekly to review progress. Stay in touch with the treating doctor after each visit to reevaluate job restrictions. Call your SFM claims representative with any updates to the injured employee's status.

Stay current on claims in progress through CompOnline. Here you can access up-to-the-minute information about what's happening on a specific claim. Work with your safety coordinator or others to prevent this type of injury from recurring.

8. Request a hard copy of the Employer Kit and keep it as your reference

It lays out the steps for reporting claims, return to work and more. Order a free copy through SFM's online "Resource catalog."

 

 



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