Workers Compensation/Disability Analyst (Analyst I-CPPW)

About the position

The City of Portland's Bureau of Fire and Police Disability and Retirement (FPDR) is seeking a qualified Workers' Compensation Disability Analyst, also known in many organizations as a Claims Examiner or Adjuster. This full-time position is responsible for the analysis and adjudication of workers' compensation claims of standard to moderate difficulty. Under the direction of the Worker's Compensation Claims Manager, the incumbent will perform analysis, investigations, and other case management functions to determine whether injuries or illnesses are occupationally related and establish the level of compensable benefits in accordance with the City Charter and FPDR Administrative Rules. The role requires facilitating employee return to work as soon as medically appropriate, while applying sound professional judgment to ensure fair and compassionate treatment of injured workers, all while protecting the City from unnecessary costs. As a Workers' Compensation/Disability Analyst, you will conduct thorough investigations of assigned claims to determine the occupational relationship of injuries or illnesses. You will be responsible for making timely claim decisions in accordance with the FPDR Charter, administrative rules, policies, and industry best practices. Regular communication with injured workers to provide claim status updates is essential, as is the management and administration of all aspects of assigned claims, including medical, return to work, legal, and subrogation matters. You will prepare reports for management and document all claims work in the FPDR database, ensuring that all actions are well-developed and lead to appropriate and timely claim closure. The ideal candidate will possess strong self-management skills, excellent time management, and task prioritization abilities to meet the daily and long-term challenges of claims work. You will be a strong communicator, able to convey complex information clearly and effectively to various stakeholders, including injured workers, medical providers, and legal counsel. As a team member, you will value partnerships and support program-wide objectives, providing excellent customer service to all parties involved in the claims process. Additionally, you will recognize the importance of equity and diversity in the workplace and commit to applying the City’s core values in your interactions with peers and the public.

Responsibilities

• Conduct thorough investigations of assigned claims to determine whether injuries or illnesses are occupationally related.
• Make timely claim decisions in accordance with the FPDR Charter, FPDR administrative rules, policies, and workers' compensation industry best practices.
• Communicate regularly with injured workers to provide claim status or other processing updates.
• Manage and administer all aspects of assigned claims, including medical, return to work, legal, and subrogation, regularly and through well-developed action plans to appropriate and timely claim closure.
• Prepare reports for management and properly document all claims work in the FPDR database.
• Perform other duties as assigned.

Requirements

• Experience adjudicating and administering workers' compensation claims, conducting medical and legal case management, facilitating early return to work, and other claims actions to bring claims to appropriate and timely resolution.
• Knowledge of reserving standards.
• Experience conveying complex medical, legal, and technical information to injured workers, medical providers, and other parties to claims verbally and in writing.
• Experience providing excellent customer service in a variety of settings, exercising patience, diagnosing the core problem, discerning the appropriate response, and providing assistance through resolution.
• Ability to understand and interpret legal and medical terminology, medical records, anatomy, and the care and treatment of occupational injuries.
• Ability to understand, interpret and apply City Charter, Administrative Rules, FPDR policies and procedures, and industry best practices in the adjudication and administration of claims.
• Must have a current active State of Oregon Claims Examiner certification at the time of application.
• Must have a valid State Driver's License and acceptable driving record at the time of hire.

Benefits

• Paid training
• Language Pay Premium Eligible for qualifying employees