Risk Analyst 3 - Workers Compensation -(Remote)- California Only

Nordstrom Inc; Santa Ana (CA); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company is seeking a Workers Compensation Risk Analyst 3 to manage complex claims and ensure compliance with laws. Responsibilities include investigating claims, negotiating settlements, and overseeing recovery processes. Candidates should have relevant experience, strong communication skills, and necessary certifications.

Benefits

Medical / Vision, Dental, Retirement and Paid Time Away

Life Insurance and Disability

Merchandise Discount and EAP Resources

Qualifications

• 2 years of workers’ compensation claims handling experience required.
• IEA Certificate and California Self Insured Certificate required.
• Ability to maintain ongoing education credits in multiple states.

Responsibilities

• Manage moderately complex claims, including high exposure and litigated claims.
• Investigate claims by contacting injured workers and medical providers.
• Calculate reserves and manage recovery processes.

Skills

Negotiation

Detail-oriented

Time Management

Communication

Education

High School Diploma or GED

Bachelor's Degree preferred

Job description

The Workers Compensation Risk Analyst 3 will be responsible for managing moderately complex claims, including high exposure and litigated claims. 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.

Position Expectations

• 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.

EDUCATION AND EXPERIENCE

High school diploma or general education degree (GED) and two years of workers’ compensation claims handling experience required. Bachelor's degree from four-year college or university preferred.

CERTIFICATES, LICENSES, REGISTRATIONS

IEA Certificate and California Self Insured Certificate required.

KNOWLEDGE AND SKILLS

• Strong understanding of workers’ compensation laws and regulations as well as workers’ compensation claim principles and application.
• Strong verbal and written communication and negotiation skills.
• Ability to work positively and collaboratively in a team environment; must always use good judgment.
• Excellent time management and organizational skills
• High level of attention to detail while working in a fast-paced environment
• Frequent use of computers, telephones, and other standard office equipment

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.