WORKERS' COMPENSATION ANALYST

Los Angeles County Metropolitan Transportation Authority (CA); Los Angeles (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

The Los Angeles County Metropolitan Transportation Authority (CA) is seeking a Workers' Compensation Analyst to evaluate claims under the California Labor Code, ensuring timely benefits and audit-ready files while coordinating with stakeholders to support efficient return-to-work outcomes.

The role conducts investigations, diaries claims, interfaces with legal, and reviews quarterly with division personnel to strategize handling of cases, while maintaining compliance with state regulations and

Qualifications

• Bachelor's Degree in Business Administration, Human Resources, or a related field.
• At least 1 year of experience examining California Workers' Compensation indemnity claims.
• Valid California Class C Driver License or ability to use transportation as needed.
• Preferred Insurance Education Association and California Workers' Compensation Self-Insured Certificates.

Responsibilities

• Evaluates claims per California Labor Code and WCAB procedures.
• Audits claim files to ensure benefits are paid correctly.
• Provides timely customer service to Metro staff and outside providers.
• Maintains claim diaries and conducts quarterly reviews with division personnel.
• Collaborates with legal to strategize appropriate claim handling.

Skills

Analytical thinking

Communication skills

Interpersonal skills

Attention to detail

Education

Bachelor's in Business Admin/HR

Job description

*****Open Until Filled: Please be aware that an interview is not guaranteed for this position and we will review candidates on a first come first serve basis. Please be sure to submit your application promptly, as the bulletin will be closed once a candidate is identified.*****

The Workers Compensation Analyst position is required to evaluate claims in accordance with the California Labor Code, and WCAB procedures, ensuring timely benefits, accurate documentation, and compliance with all state‑mandated requirements. This position works closely with stakeholders to deliver timely benefits, maintain audit‑ready files, and support effective return‑to‑work outcomes.

• Conducts journey‑level investigations upon receipt of new claims
• Reviews and responds to all incoming legal and medical mail on a timely manner in accordance with California Labor Code regulations
• Audits claim files to ensure all benefits have been paid appropriately
• Provides timely and quality customer service to all Metro staff as well as outside providers
• Maintains close working contact with injured employees and division personnel
• Maintains claim files on an effective diary system
• Meets with division personnel on a quarterly basis to review open Workers' Compensation cases
• Works closely with legal to strategize on appropriate handling of claims

May be required to perform other related job duties

Education

• Bachelor's Degree in Business Administration, Human Resources, or a related field

Experience

• One year of relevant experience examining California Workers' Compensation indemnity claims or related experience in the workers' compensation industry

Certifications/Licenses/Special Requirements

• A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job‑related essential functions
• Insurance Education Association Certificate and California Workers' Compensation Self‑Insured Certificate preferred
• Prior employers' designation Certificate required in claims handling

Preferred Qualifications (PQs) are used to identify relevant knowledge, skills, and abilities (KSAs) as determined by business necessity. These criteria are considered preferred qualifications and are not intended to serve as minimum requirements for the position. PQs will help support selection decisions throughout the recruitment. In addition, applicants who possess these PQs will not automatically be selected.

Preferred Qualifications

• Experience applying workers' compensation labor code laws when providing benefits or denying a claim
• Experience reviewing medical reports to explain timelines for the provision of benefits
• Experience conducting full‑cycle workers' compensation claims
• Experience monitoring and/or processing provisions of workers' compensation benefits, time limitations, and benefit letters
• Experience reviewing medical reports and Whole Person Impairment calculations and rating Maximum Medical Improvement reports

Knowledge of

• Theories, principles, and practices of workers' compensation claims administration
• California State Labor Code and other applicable laws, rules, and regulations governing workers' compensation
• American Medical Association Guidelines
• Permanent Disability Ratings
• Applicable business software applications

Skill in

• Performing professional workers' compensation claims administration work
• Calculating wages
• Analyzing situations, identifying problems and issues, and recommending solutions
• Exercising sound judgment when faced with complex issues
• Communicating effectively verbally and in writing
• Interacting professionally with various levels of Metro employees and outside representatives
• Conducting and reporting outcomes of roundtable sessions to discuss cases

Ability to

• Read and interpret legal reports
• Review and rate medical reports
• Work with legal representatives to resolve matters or cases
• Work aggressively to bring cases to resolution without legal actions
• Handle work assignments and meet time constraints on a strict diary system to ensure deadlines are met
• Organize and prioritize work
• Compile, analyze, and prepare comprehensive management reports
• Use good judgment when handling highly confidential information
• Understand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreements
• Travel to offsite locations
• Read, write, speak, and understand English

Special Conditions

• This job specification is not to be construed as an exhaustive list of duties, responsibilities, or requirements
• The physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job
• Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions
• This classification is at‑will and the incumbent serves at the pleasure of the hiring authority when classified as an Intermittent, Emergency, Annuitant, or Temporary employee, is assigned to the Office of Inspector General (OIG) or Board Clerk's Office, and/or reporting directly to the LACMTA Board of Directors
• Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out

Working Conditions

• Typical office situation
• Close exposure to computer monitors and video screen

Physical Effort Required

• Sitting at a desk or table
• Operate a telephone or other telecommunications device and communicate through the medium
• Type and use a keyboard and mouse to perform necessary computer‑based functions
• Communicating through speech in the English language required

(DL)