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Sr. Workers Compensation Claims Analyst



Fremont, CA, USA
Posted on Friday, February 2, 2024
What to Expect

Reporting to the Workers’ Compensation Manager, the Sr. Workers’ Compensation Claims Analyst will require an extensive background in claims adjudication, and/or risk management with direct experience in the workers’ compensation field to be successful in the position. The individual will have the ability to analyze data and readily available information to make appropriate recommendations, interpret, and apply medical and legal terminology to internal stakeholders, organize conflicting work priorities, and coordinate multiple projects with deadlines. The individual will also possess the required knowledge, skills, and abilities to work cohesively with several groups, and manage various projects both independently and collaboratively with other teams.

What You’ll Do
  • Act as main liaison to internal and external stakeholders (the affected employee, claims adjuster, HR, EHS, supervisor, and manager) for the purpose of ensuring an immediate and direct line of communication and action
  • Manage catalogue of open workers' compensation claims to focus on cost mitigation and reducing liability through continued medical treatment activity, targeted return-to-work efforts, and ongoing case progression; provide settlement authority within limits
  • Provide risk-based workers' compensation oversight as needed for day-to-day operations, project management, employee disputes, and claim escalations
  • Coordinate with dedicated operations teams for information related to accommodation of work restrictions, witness statements and workplace investigations
  • Support the internal benefits team with reviewing temporary and permanent disability benefits pertaining to workers' compensation claims, excused and unexcused absences, FMLA exhaustion and denials, short-term disability claims, and long-term disability claims
  • Conduct interactive process with employees for disputes based on escalation type; maintain contact with the ADA team as needed for return-to-work concerns, performance issues surrounding occupational injuries, and the alternate job search process for employees with permanent work restrictions
  • Coordinate with internal counsel for effective management of litigated workers' compensation claims and accompanying employment claims
What You’ll Bring
  • Bachelor’s Degree Preferred (Business Administration, Insurance or Risk Management), combination of education, training, and experience, or equivalent
  • A minimum of 5 years of experience as an indemnity workers’ compensation claims adjuster with a focus on severe injuries, complex cases, and litigation
  • A background in risk management and/or workers’ compensation claims management with a large-scale manufacturer or distributor is preferred but not required
  • An Insurance Education Association (IEA) certificate is desirable. CPCU, ARM, WCCA, WCCP and/or self-insured license is strongly preferred