Sr. Workers' Compensation Claims Analyst

Enter Job Description...

To provide administrative and professional support to the adjusters and supervisors within the Workers' Compensation Claims unit

Work Environment: In order to achieve the Agency's goals in support Of its mission. Potential candidates are required to commit and continuously practice and demonstrate the following work values:

Safety - To ensure that our employees. passengers and the general public's safety is always our first consideration.

Services Excellence - To provide safe, clean, reliable, on-tirne, courteous service for our clients and customers.

Workforce Development To make the client a learning organization that attracts, develops. motivates and retains a world-class workforce.

Fiscal Responsibility - To manage every taxpayer and customer-generated dollar as if it were coming from our own pocket.

Innovation and Technology - To actively participate in identifying best practices for continuous improvement.

Sustainability- To reduce, reuse and recycle all internal resources and reduce greenhouse gas emissions.

Integrity - To rely on the professional ethics and honesty of every client employee.

Teamwork- To actively blend our individual talents to achieve world-Class performance and service.

Examples Of Duties:

" Conducts senior analyst-level investigations upon receipt of new claims

Scope of Services

• Assists employees who have been injured on the job and processes benefits due to injured employees
• Handles issues and problems regarding injured workers who have filed claims processes medical bills and liens accumulated during an injured employee claim process
• Reviews and responds daily to all incoming legal and medical mail on a timely manner in accordance with California Labor Code regulations
• Handles claim files efficiently to ensure all benefits have been paid timely and appropriately provides quality customer service to injured employees, division personnel, and providers
• Maintains claim files on an effective diary system to aggressively handle claims and ensure timely responses
• Works closely with legal to strategize on plans of action for appropriate resolution of claims
• Mentors and trains lower-level employees
• Provides a high quantity and quality of work in accordance with departmental policies and procedures and in accordance with the California Labor Code Regulations and Requirements prepares files for presentation to division personnel as required/needed
• Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of client are carried out
• Perform other duties as assigned

Knowledge of:

• Theories, principles and practices of claims administration
• Applicable local, state, and federal laws, rules, regulations, and guidelines governing workers' compensation, disability, and vocational rehabilitation
• State Labor Code laws
• Strategies and procedures for case settlements
• Research and report preparation
• Applicable business software applications

Ability to:

• Organize and prioritize work
• Handle work assignments On a Strict diary system to ensure deadlines are met timely
• Meet time constraints and deadlines use good judgment when handling highly confidential material and information
• Follow both oral and written instructions understand, interpret, and apply laws, rules, regulations. policies, procedures, guidelines. contracts, budgets, and labor/management agreements
• Compile and analyze data
• Prepare and report statistical information
• Interact professionally with various levels of employees and outside representatives
• Read, write, Speak, and understand English

Minimum Qualifications:

Potential candidates interested in the SENIOR WORKERS COMPENSATION ANALYST position MUST meet the following requirements:

• Three (3) years of relevant experience handling. analyzing. and resolving workers' compensation claims and caseload Of varying types of employers. including California workers' compensation laws experience
• A valid California Class C Driver License Or the ability to utilize an alternative method Of transportation when needed to carry out job-related essential functions
• Prior employer's Designation Certificate
• California Self-insurers Administration Certificate preferred

EEO Employer
LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.