Workers Compensation Risk Analyst

Glidewell Dental•Irvine, CA

5d•$79,610 - $100,000

About The Position

This role oversees the full life cycle of workers’ compensation claims, developing strategies for case handling in consultation with relevant parties. The analyst enforces workers' compensation programs in alignment with company policies, partners with HR teams on overlapping matters like LOAs and employee relations to reduce liability, and manages processes for medical treatments and benefits. They interact with employees to resolve concerns, advocate for them, and ensure cost containment. The role involves conducting employer-level investigations, overseeing return-to-work processes and disability management vendors, and submitting reports to third-party administrators (TPAs). The analyst partners with TPAs, legal counsel, and injured workers to ensure proper claim resolution, diaries claims, and provides direction on proceedings. They attend hearings and trials to represent the company, respond to subpoenas, prepare case summaries, and participate in quarterly claims reviews. Additionally, the analyst identifies risk exposures and analyzes injury claims for trends, partnering with Environmental Health & Safety (EHS) and Health & Wellness (H&W) to evaluate worksites, identify hazards, and discuss corrective actions. They participate in risk management meetings, conduct workers' compensation training, and support EHS with accident investigations. The role also assists with first aid, supports offsite locations with workplace injuries and training, creates injury/incident reports, and ensures compliance with regulations and OSHA logs. Continuous learning on trends and legislative issues is expected, along with performing other duties as required.

Requirements

Minimum Seven (7) years’ experience with worker’s compensation claims, system litigation process and exposure to large deductible programs; experience with disability management, Interactive Process and LOA’s.

Nice To Haves

Bachelor’s degree in relevant field
Workers’ Compensation Claims Administration (WCCA) certification

Responsibilities

Oversees the full life cycle of workers’ compensation claim and develops strategies to handle specific cases in consultation with the appropriate parties.
Enforces workers' compensation programs in alignment with department and company policies and procedures.
Partners with other Human Resources teams on overlapping matters related individual cases involving LOAs, employee relations, grievances, and performance management concerns with a goal of employee satisfaction and reducing our liability for litigation.
Oversees workers compensation processes for medical treatments, benefits, and advocates for employees in resolving concerns and issues regarding their workers compensation claims.
Interacts with employees while maintaining high level of customer service through follow up on work statuses and satisfaction of medical treatment, and their progress in modified duties; maintains dialogue with employees for up-to-date medical documentation and advocacy when needed to limit or avoid litigation, resulting in cost containment.
Conducts employer level investigations to obtain critical information from witnesses, incident facts and evidence including company camera surveillance that help with the decision-making process of case facts and compensability.
Conducts return to work and interactive processes with injured employees, oversees outside disability management vendor on litigated cases.
Completes and submits reportable injuries/illness and findings to third party administrator (TPA); relaying proposed actions to TPA for further handling.
Partners with and supports TPA, legal counsel and injured workers on all open claims as necessary to ensure proper claim resolution.
Diaries all open claims through resolution and maintains ongoing dialogue and provides direction on proceedings with legal, claims team and physicians to ensure best case outcomes at resolution.
Attends Workers’ Compensation Appeal Board hearings, trials and depositions to represent the Company as necessary; provides pertinent case information to Defense Counsel as necessary.
Responds to subpoenas, prepares case summaries for litigated claims, and partners with Defense Counsel and TPA to ensure clear understanding of case details and company disposition.
Participates in quarterly claims review with TPA and legal counsel to discuss case updates and legal strategy towards cost effective and timely case resolution.
Identifies potential risk exposures and analyzes injury claims for potential risk trends to develop short and long-term resolution in partnership with appropriate parties to support mitigation of injuries and claims.
Partners with Environmental Health & Safety (EHS) and Health and Wellness (H&W) to evaluate employee worksites and identify potential work injury job hazards including indication of safety, ergonomics, or additional risk trends. Discusses causes and concerns with EHS, H&W, and management to begin the correction and elimination of risk concerns.
Participates in monthly risk management meetings with EHS and H&W to discuss identified risk and injury patterns and feasible action plan.
Conducts up-to-date Workers’ Compensation training to new hires, current employees, and newly promoted members of leadership.
Provides recommendations and implements improvements in injured worker and supervisor training.
Partners with EHS on safety concerns identified and suspected from the employer level investigation, for assessment and correction. Supports EHS dept. with accident investigation and safety related assignments.
Helps with first aid treatment and First Responder assistance in emergency situations and for workers compensation related incidents.
Supports all offsite locations with workplace injuries, training, protocols and provides annual regulatory insurance posting notices.
Creates and maintains monthly injury and incident reports for management and HR Teams.
Oversees compliance with internal policies, procedures, and workers compensation regulations; documents and maintains individual claim files and OSHA logs as required by Cal-OSHA.
Attend and participate in professional group meetings; stay abreast of trends and innovations in the field of workers’ compensation administration and keep current on legislative and regulatory issues at the State and Federal level.
Performs other related duties and projects as business needs require at direction of management.