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Claims Analyst - Workers Compensation

Company: Yoh, A Day & Zimmermann Company
Location: Camden
Posted on: April 11, 2021

Job Description:

Claims Analyst - Workers Compensation - -- --needed for a contract opportunity with --our client --located in Camden NJ


  • Pay Rate: $23.00/HR
  • 3 month contract with possible extension


    Role:
    The Workers-------- Compensation Claims Analyst will diligently monitor all workers-------- compensation claims across all jurisdictions with operations under the enterprise to provide guidance and recommendations to the 3rdparty WC insurance carrier/claims administrators (hereinafter -------insurer-----),
    Insurance Claims Manager, Leave Manager, Director of Risk Management and Local Management.
    Key Accountabilities
    Daily monitor and report new claims reported to follow primary roles listed above
    Monitor and manage timely internal notification, reporting and investigation of claims by operations managers, supervisors and health & safety. Such guidance and recommendations shall include the appropriate medical management track/treatment plan, timely return to work/compliance with light duty accommodations, analysis of potential credits and/or subrogation opportunities, reserve adjustments, selection and retention of medical experts, expense cost review, and the optimal case resolution strategy/indemnity evaluation to help achieve the Claims COE primary objective to drive reduction in Total Cost of Risk (-------TCOR-----).
    Monitor and maintain records for lost workdays and/or modified duty for ADA / FMLA and CBA compliance.
    Assist the insurer, Insurance Claims Manager, Leave Manager and Director of Risk Management with claim analysis including:
    Continuously monitoring claims with the assigned claims adjuster to approve/reject/revise the plan of action (e.g. Medical treatment, prior medical/prior loss impact analysis, surveillance/SIU/fraud, retention of experts/IME/DME, return to work/light duty accommodations, indemnity/expense reserves).
    Continued
    Review/Revise/Supplement the Settlement Authorization Forms prepared and submitted by the assigned claims adjuster for claims
    subject to same per the approved Special Account Claim (-------SAC-----) handling guidelines to provide settlement or optimal case resolution recommendations to the Insurance Claims Manager, Leave Manager and Director of Risk Management.
    Support the Insurance Claims Manager, Leave Manager and Director of Risk Management in the annual audit of the insurer and other workers-------- compensation claim file reviews as assigned.
    Assist LOA/HR team with transfer of WC data (e.g. lost time, modified duty, medical status) across all regions.
    Perform special assignments as assigned by the Insurance Claims Manager.
    Lead, manage, supervisor, guide local operations management and pro-actively partner with health & safety on an ongoing basis. Participate in OSHA recordkeeping discussions and internal investigations.
    Access insurer--------s online claims management data base and reporting portal to prepare and submit key claim management reports as requested by the Insurance Claims Manager, the LOA Manager and/or Director of Risk Management, including reports that address review of high-mid-low level exposure based upon total incurred, adverse trending analysis, subrogation recovery, ALAE tracking, indemnity markers and other metrics/KPIs.
    Evaluate, recommend and obtain denial or settlement authorization from Insurance Manager or Director Risk Management for applicable claims pursuant to the approved SAC handling guidelines.
    Knowledge/Skills
    Supervisory skills including training and development. Excellent oral and written communication skills. Proficiency in computer skills as well as ability to use more advanced analytical and program evaluation skills including accessing and creating reports from insurer's online claims database.

    Demonstrate an understanding of Workers-------- Compensation insurance policies coverage, terms, conditions and exclusions across all jurisdictions with operations under the enterprise.
    Knowledge of insurance claims management process nationally.
    Knowledge of water utility and related services business risks preferred.
    Proficiency with Microsoft products

    Experience/Education:
    Bachelor's level degree in Insurance/Finance from an accredited university or college or equivalent experience is preferred. High School degree is required.
    Experience in claims management within an insurance company, insurance broker or corporate risk management claims organization.
    5 years' general experience in risk management including 3 years in insurance claims management specializing in a multi-state high volume workers-------- compensation claims program. Supervisory experience in a claims management program is preferred.

    Travel Requirements:
    Approximately 10%.

    Licenses & Certifications:
    AIG, CWCP, ARM or other insurance designation is preferred.

    Apply Now!

    Recruiter: -- --LaRee Meade, laree.meade@yoh.com (WORD resumes only, please)

    Yoh makes finding and applying for jobs simple. -- Partner with Yoh to find the right opportunities across multiple industries in the US and UK. -- Find out more --! -- --

    #ZipESD

    Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Visit https://www.yoh.com/applicants-with-disabilities to contact us if you are an individual with a disability and require accommodation in the application process.PandoLogic. Keywords: Insurance Examiner, Location: Camden, NJ - 08103

Keywords: Yoh, A Day & Zimmermann Company, Camden , Claims Analyst - Workers Compensation, Professions , Camden, New Jersey

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