Risk Analyst 3 - Workers Compensation -(Remote)- California Only

$66,560 - $119,000/Yr

Nordstrom

Full-time - Mid Level

Remote

Clothing, Clothing Accessories, Shoe, and Jewelry Retailers

About the position

The Workers Compensation Risk Analyst 3 at Nordstrom is a pivotal role responsible for managing moderately complex workers' compensation claims, including those with high exposure and litigated claims. This position requires a thorough investigation of claims, which involves timely communication with injured workers, medical providers, and employer representatives. The analyst must document all investigation efforts and findings in accordance with internal claims management guidelines and applicable laws. A critical aspect of the role is to determine the validity of claims under relevant workers' compensation statutes and to communicate effectively with medical providers to develop and authorize appropriate treatment plans. In addition to managing claims, the Risk Analyst will review and analyze medical bills to ensure that charges and treatments are related to the work injury and comply with the treatment plan. Timely payment of medical bills and income replacement is essential, and the analyst must ensure that these payments are made in accordance with applicable fee schedules and statutes. The role also involves calculating and assigning appropriate reserves to claims, managing reserve adequacy throughout the claim's lifecycle, and overseeing claim recoveries, including subrogation and offsets from Social Security and Medicare. The position requires the preparation of necessary state filings within specified time limits and collaboration with outside counsel to provide information and strategic direction for litigation and settlement negotiations. Continuous education credits in multiple states are also a requirement for this role, ensuring that the analyst remains knowledgeable about evolving workers' compensation laws and practices.

Responsibilities

• Thoroughly investigate workers' compensation claims by contacting injured workers, medical providers, and employer representatives/witnesses.
• Determine the validity of claims under applicable workers' compensation statutes.
• Communicate with medical providers to develop and authorize appropriate treatment plans.
• Review and analyze medical bills to confirm charges and treatment are related to the work injury and in accordance with the treatment plan.
• Ensure timely payments for medical bills and income replacement in accordance with applicable fee schedules and statutes.
• Calculate and assign appropriate reserves to claims and manage reserve adequacy throughout the life of the claim.
• Manage claim recoveries, including subrogation, second injury fund excess recoveries, and Social Security and Medicare offsets.
• Prepare required state filings within applicable time limits.
• Oversee and work with outside counsel to provide information and strategic direction for litigation and/or settlement negotiations.
• Maintain ongoing education credits in multiple states.

Requirements

• High school diploma or general education degree (GED) and two years of workers' compensation claims handling experience required.
• Bachelor's degree from a four-year college or university preferred.
• IEA Certificate and California Self Insured Certificate required.
• Strong understanding of workers' compensation laws and regulations as well as claim principles and application.
• Strong verbal and written communication and negotiation skills.
• Ability to work positively and collaboratively in a team environment.
• Excellent time management and organizational skills.
• High level of attention to detail while working in a fast-paced environment.

Benefits

• Medical/Vision, Dental, Retirement and Paid Time Away
• Life Insurance and Disability
• Merchandise Discount and EAP Resources