Senior Claims Analyst

MasterCorp, Inc.•Orlando, FL

1d•Onsite

About The Position

The Senior Claims Analyst supports the administration, investigation, analysis, and resolution of workers' compensation and casualty claims programs. This role partners with TPAs, insurance carriers, and internal stakeholders to support claim management, regulatory compliance, return-to-work initiatives, claim audits, and quarterly claim reviews. The position is responsible for claims reporting, trend analysis, and identifying opportunities to improve claim outcomes, reduce risk, and enhance operational processes. The Senior Risk Analyst provides recommendations and operational support to the Senior Risk Manager regarding claim strategy, reserve concerns, compliance matters, and program performance.

Requirements

College degree and/or equivalent work-related experience.
5+ years of claims, workers' compensation, risk management, or insurance-related experience.
Strong knowledge of workers' compensation, casualty claims, insurance claims administration, and risk management principles.
Proficient with Office 365 (Outlook, Word, Excel, and PowerPoint)
Excellent planning and organization skills
Expense Management

Nice To Haves

Claims adjuster certifications
Bilingual English/Spanish

Responsibilities

Serve as the primary administrator for the Company's workers' compensation program, managing claims from first report of injury through closure, including claim reporting, documentation, claim status monitoring, return-to-work coordination, and communication with employees, medical providers, TPAs, carriers, and regulatory agencies.
Support administration of casualty claims, including general liability, auto, guest injury, property damage, theft, and other operational claims, ensuring timely investigation, documentation, and resolution in accordance with company procedures.
Serve as a resource to managers and associates regarding workers' compensation procedures, claim reporting requirements, return-to-work processes, and applicable state regulations.
Maintain accurate claim files and records within risk management, TPA, and claims management systems, including claim notes, work status updates, medical documentation, and related correspondence.
Prepare reports and trend analyses related to claim frequency, severity, lag time, lost workdays, medical utilization, and other key risk metrics, providing insights and recommendations for risk mitigation and process improvement.
Coordinate return-to-work and light duty programs, including work status tracking, light duty offers, payroll coordination, and related recordkeeping.
Conduct and support claim investigations by gathering and reviewing incident reports, witness statements, police reports, photographs, medical documentation, and other supporting evidence.
Monitor open claim inventory, identify claim trends and potential exposure concerns, and provide recommendations to the Senior Risk Manager regarding claim resolution and risk mitigation opportunities.
Support quarterly claim reviews, claim audits, subrogation efforts, and ongoing collaboration with TPAs, carriers, brokers, and legal partners as needed.
Maintain OSHA compliance activities, including recordkeeping, inspections, annual summaries, injury/illness tracking, and required postings.
Perform periodic claim file reviews and audits to ensure data integrity, regulatory compliance, and adherence to company claims procedures.
Support company safety and risk management initiatives, including driver qualification reviews, slip-resistant footwear programs, and other loss prevention efforts.
Collaborate with Operations, Human Resources, Safety, Legal, Finance, TPAs, and insurance partners to support claim resolution, regulatory compliance, and continuous process improvement.
Provide guidance and support to Claims Coordinators regarding claim processes, documentation requirements, and system administration.
Maintain claim-related correspondence, records, and electronic filing systems.
Assist with claim payment tracking, reporting, and related administrative functions.
Monitor departmental KPIs and identify opportunities to improve claim handling efficiency, compliance, and service levels.
Support implementation of risk, safety, and compliance initiatives directed by leadership.