Workers Compensation Risk Analyst 3

Summary

The Workers Compensation Risk Analyst 3 manages moderately complex workers’ compensation claims, including high-exposure and litigated cases. The role determines benefits, ensures compliance with applicable laws and internal guidelines, and manages subrogation and settlement opportunities. This position works in a hybrid environment and reports to the Risk Claims Supervisor.

Responsibilities

• Investigate claims, determine validity, document findings, and manage claims in accordance with applicable statutes and guidelines.
• Coordinate appropriate medical treatment, review bills, and ensure timely payment of medical and income-replacement benefits.
• Manage time-loss claims, reserves, recoveries, state filings, and offsets.
• Work with outside counsel on litigation and settlement negotiations.
• Handle claims across multiple state jurisdictions and attend scheduled in-office days.

Requirements

• High school diploma or GED and at least two years of workers’ compensation claims-handling experience.
• Bachelor’s degree and IEA or California Self Insured Certificate preferred.
• Strong knowledge of workers’ compensation laws, regulations, and claims principles.
• Strong communication, negotiation, organization, time-management, and attention-to-detail skills.
• Ability to maintain continuing education credits and work collaboratively in a hybrid environment.