Workers Compensation Claims Analyst 2

Mitchell International • Egg Harbor Township, NJ

449d • $53,332 - $67,785

About The Position

The Workers' Compensation Claims Analyst 2 position at Coventry involves managing high exposure, complex, and catastrophic workers' compensation claims in New Jersey. The role requires evaluating claimant eligibility, communicating with various stakeholders, and ensuring compliance with jurisdictional requirements. The analyst will work closely with claimants, physicians, and employers to facilitate effective claim management and return-to-work processes, while also identifying potential recovery opportunities and managing litigation when necessary.

Requirements

• High School diploma required; Associate's or Bachelor's degree preferred, or five or more years of equivalent work experience in an insurance, medical/health, or legal related industry.
• At least 5-6 years of experience handling New Jersey workers' compensation claims required.
• Completion of Workers' Compensation training courses in significant areas affecting claims handling and practices.
• Workers' Compensation licenses, certifications, or awards preferred.

Responsibilities

• Evaluate claimant eligibility and communicate with attending physician, employer, and injured worker.
• Manage high exposure, complex, and catastrophic claims.
• Work with claimants and their physicians to medically manage claims from initial treatment to ongoing evaluations.
• Facilitate return-to-work processes with employers, either full-time or modified duty.
• Identify potential for third-party recovery and pursue reimbursement processes.
• Identify potential for disability or pension credits and apply them where appropriate.
• Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
• Establish claim reserve levels and maintain them throughout the claim's life.
• Comply with excess and reinsurance reporting requirements.
• Establish compensability status through investigation and evaluation of jurisdictional laws.
• Complete payment authorization requests when applicable.
• Evaluate exposure in cases of litigation and work with defense counsel to establish defenses and manage litigation.
• Manage diary in accordance with Best Practices to ensure timely resolution of cases.

Benefits

• Medical, Dental, Vision insurance
• Health Savings Accounts / Flexible Spending Accounts
• Life and AD&D Insurance
• 401(k)
• Tuition Reimbursement
• Resources for healthier living

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Publishing Industries
• Education Level: High school or GED