Lead Analyst - Claims Management

Location: Kirkwood or Rochester, NY. Reports to: Director - Health & Wellness. Work Type: Office.

About the role

Develops, implements, monitors and takes primary responsibility for handling a broad range of workers compensation insurance claims for New York (NYSEG and RG&E). Assignments may include a range of specialized assignments within the Insurance and Health & Safety disciplines.

Responsibilities

• Involved in day-to-day administration of Insurance Programs and renewal process.
• Identify potential gaps in coverage and makes recommendation for modification to the insurance program of Avangrid (and subsidiaries).
• Coordinates the preparation of insurance renewal applications.
• Administers the workers compensation program(s).
• Processes claims with insurance carrier, determines third party recovery potential, oversees the light duty program, salary continuation, return to work/light-duty programs, monitors and administrates salary continuation and disability payments, monitors and makes reserve recommendations, attends workers compensation hearings, and reviews claims with insurance carrier or third-party administrators.
• Process and reconcile retained loss cost invoices and records.
• Administers referrals, communications, and information between employees, supervisors, and with a workers compensation case management vendor.
• Negotiates and settles claims in accordance with company policy.
• Works directly with legal staff and outside counsel on larger claims.
• Assists Human Resources in the interpretation of FMLA, ADA and OSHA regulations and working with directly with employees claims.
• Supports management with corporate goals related with cost reduction through improved methods, procedures, and insurance program changes.
• Oversee and be responsible to workers compensation-related software applications (Stars, SAP).
• Maintain OSHA Records (Lost-time, Medical only) records and loss report

Requirements

• Associates degree required or equivalent combination of education and experience.
• Bachelors preferred.
• 3+ years of workers compensation-specific and company-specific experience is desired.
• Requires thorough knowledge of State workers compensation regulations, ADA, FMLA, and applicable bargaining unit contract language.
• Basic knowledge of financial accounting principles and practices.

Skills

• Self-motivated, self-directed, organized and capable of managing multiple tasks and operating independently.
• Excellent analytical, critical thinking, decision-making and problem-solving skills.
• Strong verbal and written communication skills.
• Strong customer service orientation.
• Can effectively communicate with all levels of staff and management and act as intermediary between internal functional areas, case management vendors and workers compensation insurance carriers.
• Change management skills.
• Team-oriented, skilled in building consensus and a collaborative environment.
• Ability to interpret technical and business requirements into a workers compensation claims management solution.
• Ability to travel within designated region as needed.

Benefits

• Competitive benefits and growth opportunities
• Generous performance‑based bonuses
• 12% 401(k) match
• Comprehensive health, dental, and vision insurance
• Tuition reimbursement
• Professional development and clear career advancement pathways

Pay

The salary range for this position is based on experience level ranging from $84,000 to $109,500 plus up to 16