Workers' Compensation Claims Analyst

About the Role

Peoplease is looking for a qualified Workers' Compensation Claims Analyst to manage a caseload of complex workers’ compensation insurance claims for our client’s employees. The purpose of this role is to determine compensability, monitor reserves, and aggressively negotiate settlement of claims. This position is accountable for the quality of claim services as perceived by Peoplease clients and within our corporate claim standards.

Responsibilities

• Manage a caseload of WC claims in multiple jurisdictions which may be outside the assigned region
• Investigate and monitor claims in accordance with established claims handling procedures using company guidelines
• Manage all open work comp claims for assigned multistate territories (Approx. 175-200 claims) with a mix of Med Only and indemnity/loss time
• Give recommendations to carrier/TPA for ways to help lower the cost of the claims as well as getting the claim closed
• Handle all litigation requests from attorneys
• Review and evaluate settlement authority, reserve requests within assigned authority levels
• Assess and monitor subrogation claims for resolution
• Delivery of quality claim oversight to clients
• Participate in QBR's and client claim reviews
• Guide and educate clients on proper claim reporting
• Review medical, legal and miscellaneous file documentation to determine if reasonable and related to the ongoing claim
• Liaison between the client and insurance carrier/TPA
• Assist in selection and supervision of defense attorneys
• Prepare reports detailing claims, payments and reserves
• Prepare and participate in claims reviews
• Compliance with Service Commitments as established by team
• Multitask between internal RMIS Systems – Carrier/TPA/Peoplease
• Performs other duties as assigned within scope of role

Qualifications

• 3+ years of WC claim experience and/or TPA claims oversight experience required
• 8am-5pm PST or MST work schedule
• PEO or Staffing WC claims oversight experience a plus
• Additional WC claims management experience in multiple jurisdictions a plus
• Ideal candidate will have experience working as a remote employee in a distributed work team
• Must be detail oriented
• Must be able to meet deadlines
• Proficient with Microsoft Office products

Skills

• Ability to manage and execute the coordination of multiple projects within required timeframes and expectations
• Demonstrated excellence in communication skills; able to inform both orally and in writing
• Working knowledge of Microsoft Office products
• Ability to perform detail-oriented tasks
• Ability to interact, coordinate, follow up, and effectively communicate with WC team members, regional teams, Senior Management, and Third-Party Administrators
• Self-starter with the ability to function as a remote employee with a Pacific Standard Time (PST) / Mountain Standard Time (MST) work schedule in a distributed work team

Benefits

• Competitive salary and benefits package

Work Environment

The role requires regular communication and occasional travel to support the distributed workforce. The role will primarily function indoors but may involve working in varying temperatures or outdoor environments as needed.