Workers Compensation Claims Analyst

Peoplease; Orlando (FL); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a skilled Workers' Compensation Claims Analyst to join their dynamic team. This role involves managing a diverse caseload of complex workers' compensation claims while ensuring high standards of service and client satisfaction. The ideal candidate will thrive in a remote work environment, showcasing strong communication and negotiation skills, coupled with a detail-oriented approach. Join a company that values integrity and service excellence, and make a significant impact in the lives of clients and their employees. If you are passionate about claims management and eager to contribute to a collaborative team, this opportunity is perfect for you.

Qualifications

• 3+ years of WC claims experience required, ideally in a remote team.
• Proficient in detail-oriented tasks and meeting deadlines.

Responsibilities

• Manage a caseload of WC claims across multiple jurisdictions.
• Investigate claims and negotiate settlements effectively.
• Provide quality oversight and educate clients on claims.

Skills

Workers' Compensation Claims Management

Negotiation Skills

Communication Skills

Detail Orientation

Project Coordination

Tools

Microsoft Office

Job description

About Peoplease

Peoplease is a leading Professional Employer Organization (PEO) providing solutions to small and medium-sized businesses in the blue and gray-collar industries. We enable our clients and partners to achieve their aspirations by offering world-class service and administrative solutions in payroll, human resources, benefits, and risk management. At Peoplease, we foster a culture of inclusion and belonging, driven by our core values: Engagement, Integrity, Tenacity, Curiosity, Happiness, and a Service-obsessed mindset.

Position Summary

Peoplease is looking for a qualified Workers' Compensation Claims Analyst to join our team. The purpose of the Claims Department is to manage a caseload of complex workers’ compensation insurance claims for our client’s employees. The

Workers' Compensation Claims Analyst will help the Claims Department by determining compensability, monitoring reserves, and aggressively negotiating settlement of claims. Additionally, this position is accountable for the quality of claim services as perceived by Peoplease clients and within our corporate claim standards.

An ideal candidate will have the ability to manage and execute the coordination of multiple projects within required timeframes and expectations; demonstrated excellence in communication skills; be able to inform both orally and in writing; working knowledge of Microsoft Office products. Demonstrate the ability to perform detail-oriented tasks; interact, coordinate, follow up, and effectively communicate with WC team members, regional teams, Senior Management, and Third-Party Administrators.

Candidate must be a self-starter with the ability to function as a remote employee in a distributed work team.

Essential Duties and Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Manage a caseload of WC claims in multiple jurisdictions which may be outside the assigned region
• Investigate and monitor claims in accordance with established claims handling procedures using company guidelines
• Manage all open work comp claims for assigned multistate territories (Approx. 120-160 claims) with a mix of Med Only and indemnity/loss time
• Give recommendations to carrier/TPA for ways to help lower the cost of the claims as well as getting the claim closed
• Handle all litigation requests from attorneys
• Review and evaluate settlement authority, reserve requests within assigned authority levels
• Assess and monitor subrogation claims for resolution
• Delivery of quality claim oversight to clients
• Participate in QBR’s and client claim reviews
• Guide and educate clients on proper claim reporting
• Review medical, legal and miscellaneous file documentation to determine if reasonable and related to the ongoing claim
• Liaison between the client and insurance carrier/TPA
• Assist in selection and supervision of defense attorneys
• Prepare reports detailing claims, payments and reserves
• Prepare and participate in claims reviews
• Compliance with Service Commitments as established by team
• Multitask between internal RMIS Systems – Carrier/TPA/Peoplease
• Performs other duties as assigned within scope of role

Minimum Qualifications (Knowledge, Skills, and Abilities)

• 3+ years of WC claim experience and/or TPA claims oversight experience required
• PEO or Staffing WC claims oversight experience a plus
• Additional WC claims management experience in multiple jurisdictions a plus
• Ideal candidate will have experience working as a remote employee in a distributed work team
• Must be detail oriented
• Must be able to meet deadlines
• Proficient with Microsoft Office products