Claims Analyst - Workers Compensation
Company: Yoh, A Day & Zimmermann Company
Posted on: April 11, 2021
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
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
Insurance Claims Manager, Leave Manager, Director of Risk
Management and Local Management.
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).
Review/Revise/Supplement the Settlement Authorization Forms
prepared and submitted by the assigned claims adjuster for
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
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
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.
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
Proficiency with Microsoft products
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
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.
Licenses & Certifications:
AIG, CWCP, ARM or other insurance designation is preferred.
Recruiter: -- --LaRee Meade, firstname.lastname@example.org (WORD resumes
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 --! -- --
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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