Workers' Compensation Claims Analyst

MGM Resorts International; Las Vegas, Northern (NV, KY); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Wellness incentive programs

Discounts on hotel, F&B, retail, and娱乐

Free parking on and off shift

Health & Income Protection benefits

Professional and personal development

Job summary

MGM Resorts International is seeking a Workers' Compensation Claims Analyst to manage investigations and administration of claims handled by Third-Party Administrators, with direct oversight of Nevada claims and collaboration with other states under leadership guidance.

The role requires coordinating with TPA adjusters, property leadership, and injured employees, auditing claim files, and identifying cost-containment strategies while ensuring compliance with regulatory requirements.

Qualifications

• Has a High School Diploma or GED.
• Has 3+ Years of prior relevant experience working for a public company in the State of Nevada.
• Has a Bachelor's Degree - Preferred.
• Nevada State Worker's Compensation license - Preferred.
• Previous experience working in a similar resort setting - Preferred.

Responsibilities

• Manage and serve as the company claim advocate for Worker's Compensation claims administered by TPAs nationwide.
• Serve as the primary key contact with the TPAs, MGM department leaders, and the injured worker to ensure timely and appropriate administration of claims.
• Supervise TPA administration for quality assurance, appropriate claim management, control of medical management services, and oversight of litigation expenses.
• Carryout oversight and audit processes to monitor the TPA's adherence to their Best Practices and agreed upon Special Handling Instructions.
• Oversee Worker's Compensation claims the handling of the Companies Nevada, Michigan, Ohio, Massachusetts, Maryland, New York, New Jersey and Mississippi Workers' Compensation claims reviewing notes in TPA Risk Management Systems including, but not limited to, data entry, claim reporting, appropriate medical management, reserving, timely claimant communication, documentation, litigation, settlement negotiations, and return to work protocol.

Job description

US, Nevada The SHOW comes alive at MGM Resorts International

Have you ever wondered what it would be like to work in a place full of excitement, diversity, and entertainment? Are you enthusiastic about being a team player in one of the most fascinating industries in the world? At MGM Resorts, we seek individuals like YOU to create unique and show-stopping experiences for our guests.

THE JOB

The primary purpose of the Workers' Compensation Claims Analyst is to manage the investigation and administration of all Workers' Compensation claims handled by Third-Party Administrators (TPAs), ensuring program excellence and the success of our collaborative team. This role maintains direct, day-to-day oversight of the company’s Nevada claims, serving as the frontline liaison between domestic Nevada property management and TPA adjusters to ensure claims are resolved thoroughly and compliantly. Additionally, the Analyst provides collaborative, escalated oversight and administrative liaison support for claims in Michigan, Ohio, Massachusetts, Maryland, New York, New Jersey, and Mississippi, under the direct guidance and supervision of the Director. The Analyst reviews and audits claim files for accuracy, provides critical financial alerts to the Director on high-impact claims, and utilizes critical thinking to conduct proactive communication with internal and external partners, as well as with injured employees when necessary or as directed by leadership.

THE DAY-TO-DAY

• Manage and serve as the company claim advocate for Worker's Compensation claims administered by TPAs nationwide.
• Serve as the primary key contact with the TPAs, MGM department leaders, and the injured worker to ensure timely and appropriate administration of claims.
• Supervise TPA administration for quality assurance, appropriate claim management, control of medical management services, and oversight of litigation expenses.
• Carryout oversight and audit processes to monitor the TPA's adherence to their Best Practices and agreed upon Special Handling Instructions.
• Oversee Worker's Compensation claims the handling of the Companies Nevada, Michigan, Ohio, Massachusetts, Maryland, New York, New Jersey and Mississippi Workers' Compensation claims reviewing notes in TPA Risk Management Systems including, but not limited to, data entry, claim reporting, appropriate medical management, reserving, timely claimant communication, documentation, litigation, settlement negotiations, and return to work protocol.
• Works closely with the Director of Worker's Compensation in identifying trends and areas for program improvement.
• Conduct and facilitate claim reviews on a quarterly basis with the TPA adjusters to ensure TPA compliance with MGM requirements and quality assurance standards.
• Oversight of the TPA adjuster files for proper evidence and a plan for case resolution.
• Identify cases that should resolve and work with the adjuster to resolve at the earliest opportunity.
• Establishes a cadence of regular interactions with key TPA claims personnel to ensure alignment of expectations and strengthening of the partnership.
• Works collaboratively with the TPA claims handlers to develop strategies for cost containment and claim resolution.
• Responsible for collaborating with Company Return to Work Specialists and ADA Department to follow corporate guidelines regarding permanent restriction processes.
• Provide education and training to departments as needed, aimed to reduce frequency of injuries.
• Serve as a resource to the injured employee to assist in navigation of the Work Comp claims process.
• Weekly management of Work Comp claims system in order to supply relevant data to OSHA 300 and 301 logs, in coloration with the Safety Department, to ensure compliance with all federal, state, and local reporting requirements.
• Remains up to date of worker's compensation regulations, laws and ruling.
• Other projects and tasks as necessary and required by the Director of Worker's Compensation, VP of Risk Management, and other Risk Management department leaders.

THE IDEAL CANDIDATE

• Has a High School Diploma or GED
• Have 3+ Years of prior relevant experience working for a public company in the State of Nevada
• Has a Bachelor's Degree - Preferred
• Nevada State Worker's Compensation license - Preferred
• Previous experience working in a similar resort setting - Preferred

THE PERKS & BENEFITS

• Wellness incentive programs to help you stay healthy physically and mentally
• Access to company hotel, food and beverage, retail, and entertainment discounts as well as discounts with company partners on things like travel, electronics, online shopping, and more
• Free parking on and off shift
• Health & Income Protection benefits (for eligible employees)
• Professional and personal development through programs and networking opportunities as well as volunteer opportunities in the community

At MGM Resorts, we exist to entertain the human race and provide an unforgettable escape. From delivering excellence for our guests to building and sustaining our communities, you can join our diverse teams of world‑class talent and thrive in our collaborative environment. Our iconic MGM Resorts brands offer everyone a wide variety of exciting career opportunities with access to unlimited growth. Be part of a unique world filled with anticipation, entertainment and unparalleled experiences — combined with competitive rewards and exclusive perks. Together, we will use our meaningful relationships to continue to build our authentic culture. We know the importance of respecting each other’s differences. We embrace and leverage our diversity to achieve best-in-class experiences and create stronger ties with our employees, guests, suppliers and community partners. We stay committed to taking strong, principled stands on equality to better unify our world.

MGM Resorts International develops, builds and operates unique destination resorts designed to provide a total resort experience, including first-class accommodations and dining, world-class entertainment, state-of-the-art meeting and convention facilities, and high-quality retail and gaming experiences. We know the importance of respecting each other’s differences. We embrace and leverage our diversity to achieve best-in-class experiences and create stronger ties with our employees, guests, suppliers and community partners. We stay committed to taking strong, principled stands on equality to better unify our world. MGM Resorts International believes in providing opportunity for every employee to grow, develop and succeed in a work environment where you can be your best.

If you are an individual with a disability and need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please contact us at [e-mail]

We are an Equal Opportunity Employer.

We are also committed to protecting the privacy of visitors to our employment application site, including the protection of any personal information provided to us.

For more information about MGM Resorts International, including our privacy policy and commitment to diversity and inclusion, please visit http://www.mgmresorts.com/careers.

For California residents, also see our California Privacy Notice that describes the categories of personal information and sensitive personal information we collect and provides certain details about our processing of that information.