Workers Compensation Analyst

Superior Grocers•Santa Fe Springs, CA

4d•$28 - $33•Onsite

About The Position

The Workers Compensation Analyst position involves receiving first notice of injuries from stores via various channels such as Nurse Triage Reporting, email, or phone calls. The analyst is responsible for maintaining an accurate log of all received injury reports, setting up initial claim files, and reporting to the insurance company/TPA. This role requires constant communication with the injured worker, the store, the insurance company, medical providers, and any involved attorneys. The analyst must maintain updated medical status on all open files, assign investigators when necessary, and summarize settlement authority requests for upper management. They will also attend and participate in quarterly claims reviews with the insurance carrier/TPA, coordinate modified duties for injured workers (on or offsite), review and approve medical bills related to pre-employment and post-injury care, and generate monthly and quarterly reports for the Director of Risk. Collaboration with Human Resources is essential for obtaining pertinent information and providing claim status updates.

Requirements

High School Diploma or Equivalent
2-5 years experience in handling Workers Compensation claims.
1-3 years experience dealing with Self Insured employer.
Proficiency in Microsoft applications (e.g.-Excel, Outlook, Word, Power Point).
Experience with managing a claims Database system.
Typing 35 WPM
Experience with 10 key, fax and multi-line phone system.
Excellent communication skills required.
Good interpersonal skills.
Be able to deal with delicate situations and maintain confidentiality.
Ability to interact and work in conjunction with other departments within the company.
Ability to work independently.
Analytical and Problem-Solving skills.

Nice To Haves

College Degree Preferred
Professional Certification (WCCA/WCCP) desirable
Bi-Lingual preferred – English/Spanish

Responsibilities

Daily data entry into the Workers Compensation log and into the database (WCCMS).
Setting up the initial file for injury and determining if it needs to be reported to the insurance company, is a Medical Only, Indemnity claim, or a possible non-industrial incident.
Investigate new losses and report losses to TPA/Carrier with supportive documentation.
Assisting two Districts and managing all losses and working with the TPA.
Serve as a liaison between Operations and TPA for the workers compensation claims process.
Participate in claims review with the insurance carrier/TPA.
Document file activities in accordance with established policy and maintain an effective diary management system for timely claim handling.
Coordinate return to work program with injured workers, Stores, and TPA.
Maintain updated medical status on all open files.
Daily communication with injured workers, stores, and insurance company.
Generate weekly reports regarding modified duty status.
Provide support to adjuster and defense counsel in securing all documents for discovery.
Log new claims into Open Claims for the pertaining month.
Generate weekly, monthly, quarterly reports as needed by senior management.
Follow-up with store management, vendors, and injured workers on a daily basis.
Regularly review files for closure and request claim status updates.
Review and document claim work status reports.
Provide the Human Resources department with updated information as it affects their respective departments.
Provide monthly charge back report to CFO.
Review and analyze video surveillance for all injuries.
Participate in WC presentations when necessary.
Assist the Risk Department with all the responsibilities required to maintain optimal department efficiency.
Review all video on claims reported by the Stores.
Attach video result into the claim folder for use.
Advise Loss prevention on any problems with store video system.