Risk Analyst 3 - Workers Compensation

Brobston Group

Full-time - Mid Level

Remote

About the position

The Workers Compensation Risk Analyst 3 is responsible for managing moderately complex workers' compensation claims, including high exposure and litigated cases. This remote position requires candidates to be located in California and involves thorough investigation, communication with medical providers, and ensuring compliance with applicable statutes and regulations.

Responsibilities

• Thoroughly investigate workers' compensation claims by timely contacting injured workers, medical providers, and employer representatives/witnesses and documenting investigation efforts and findings within claim management guidelines.
• Determine if claims are valid 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 payments for medical bills and income replacement are remitted on a timely basis 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 but not limited to 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 as needed for litigation and/or settlement negotiations.
• Maintain on-going education credits in multiple states.

Requirements

• High school diploma or 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 workers' compensation claim principles and application.
• Strong verbal and written communication and negotiation skills.
• Ability to work positively and collaboratively in a team environment; must always use good judgment.
• Excellent time management and organizational skills.
• High level of attention to detail while working in a fast-paced environment.
• Frequent use of computers, telephones, and other standard office equipment.