claims analyst - workers compensation

$62,379 - $62,400/Yr

Randstad - Austin, TX

Full-time - Entry Level

Austin, TX

Administrative and Support Services

About the position

The Claims Coordinator will manage the Return-to-Work program and workers' compensation claims, focusing on coordinating the return-to-work process for injured employees while ensuring compliance with regulations. This role involves tracking claims, communicating with claimants, and collaborating with medical professionals and managers to facilitate a smooth and timely return to work, ultimately contributing to the success of the Workers' Compensation program.

Responsibilities

• Support workers' compensation claims from initial filing through resolution, ensuring compliance with state regulations.
• Coordinate with injured workers, supervisors, and medical professionals to gather relevant information for evaluating claims.
• Recommend medical reviews, case management, medical bill auditing, and vocational services as necessary.
• Collaborate with adjusters and dealers to ensure timely acceptance of medical restrictions and to limit unnecessary time off, minimizing lost work days.
• Investigate cases to identify potential compliance issues and fraudulent activity, recommending further investigation if needed.
• Support the return-to-work process by engaging with stakeholders for modified work duties and restrictions for injured workers.
• Build and maintain positive relationships with stakeholders to facilitate smooth return-to-work procedures.
• Monitor and enforce adherence to workers' compensation policies and state regulations during claim resolution.
• Conduct regular reviews and analyses of claims to identify trends, risks, and areas for improvement.
• Maintain accurate records of claim progress, including setting appropriate reserves and generating status reports for management review.

Requirements

• Bachelor's degree required.
• 2 years of experience in claims processing or related field.
• 1 year of experience in return to work programs.
• 1 year of experience with Risk Connect.
• 2 years of experience with Excel.

Benefits

• Health insurance coverage
• 401K contribution
• Incentive and recognition program