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The Workers Compensation Risk Analyst 3 will be responsible for managing moderately complex claims, including high exposure and litigated claims. This is an intermediate role on the team, not a senior role. Responsibilities include determining benefits due; ensuring management of claims within internal claims management guidelines and in compliance with applicable laws; and identifying opportunities for, managing subrogation of claims, and negotiating settlements.
This position is a remote “work from home” position - Must be located in California.
A day in the life:
Thoroughly investigate workers’ compensation claims by timely contacting injured workers, medical providers, and employer representatives/witnesses and documenting investigation efforts and findings within claim management guidelines.
Determine if claims are valid under applicable workers’ compensation statutes.
Communicate with medical providers to develop and authorize appropriate treatment plans.
Review and analyze medical bills to confirm charges and treatment are related to the work injury and in accordance with the treatment plan.
Ensure payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statutes.
Calculate and assign appropriate reserves to claims and manage reserve adequacy throughout the life of the claim.
Manage claim recoveries, including but not limited to subrogation, second injury fund excess recoveries, and Social Security and Medicare offsets.
Prepare required state filings within applicable time limits.
Oversee and work with outside counsel to provide information and strategic direction as needed for litigation and/or settlement negotiations.
Ability to maintain on-going education credits in a multiple state.
You own this if you have:
At least 2 years direct workers compensation experience (actually working claims)
Experience with Indemnity claims (not just medical only)
Adjuster training hours for the past 2 years (must be recent -(state requires 30 hours)
Must be located in California.
Strong Customer service skills a must
Good understanding of workers’ compensation laws and regulations as well as workers’ compensation claim principles and application.
IEA OR California Self Insured huge plus
Must have a high attention to detail while working in a fast-paced environment
Must have computer experience and be good with MS Office Suite
We’ve got you covered…
Our employees are our most important asset and that’s reflected in our benefits. Nordstrom is proud to offer a variety of benefits to support employees and their families, including:
Medical/Vision, Dental, Retirement and Paid Time Away
Life Insurance and Disability
Merchandise Discount and EAP Resources
A few more important points...
The job posting highlights the most critical responsibilities and requirements of the job. It’s not all-inclusive. There may be additional duties, responsibilities and qualifications for this job.
Nordstrom will consider qualified applicants with criminal histories in a manner consistent with all legal requirements.
Applicants with disabilities who require assistance or accommodation should contact the nearest Nordstrom location, which can be identified at www.nordstrom.com.