Workers Compensation, Risk Analyst 3 (Hybrid)

Nordstrom; Fullerton (CA); Hybrid; USD 69,000 - 111,000; Full time

Benefits offered by this job

Medical/Vision, Dental, Retirement and

Paid Time Away

Merchandise Discount and EAP Resources

Job summary

Nordstrom is seeking an experienced Workers’ Compensation Risk Analyst 3 to manage moderately complex claims including high exposure and litigated cases. You will determine benefits, ensure compliance with laws, and oversee subrogation and settlements.

The role reports to the Risk Claims Supervisor and supports a claims team in a hybrid environment. A day in the life includes investigating claims, validating eligibility, coordinating treatment, managing time loss, and handling reserves and

Qualifications

• High school diploma or GED and two years of workers’ compensation claims handling experience required.
• Bachelor’s degree from four-year college or university preferred.
• IEA Certificate or California Self-Insured Certificate preferred.

Responsibilities

• Thoroughly investigate workers’ compensation claims by contacting injured workers, providers, and employer representatives.
• Determine if claims are valid under applicable workers’ compensation statutes.
• Communicate with medical providers to develop and authorize appropriate treatment plans.
• Manage time loss claims with proactive efforts for early return to work.
• Review and analyze medical bills to ensure charges relate to work injuries and treatment plans.
• Ensure timely payments of medical bills and income replacement per fee schedules and statutes.
• Calculate and assign reserves and manage reserve adequacy throughout the life of the claim.
• Oversee subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets.
• Prepare state filings within statutory limits and assist litigation as needed.
• Collaborate with outside counsel for litigation and settlement direction.

Skills

Workers' compensation laws

Claims handling

Communication skills

Negotiation

Team collaboration

Education

GED/High school diploma

Bachelor's degree preferred

Job description

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 applicable laws; and identifying opportunities for and managing subrogation of claims and negotiating settlements. This is an intermediate claims examiner position that reports directly to the Risk Claims Supervisor.

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 applicable laws; and identifying opportunities for and managing subrogation of claims and negotiating settlements. This is an intermediate claims examiner position that reports directly to the Risk Claims Supervisor.

A day in the life...

• 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.
• Manage time loss claims with proactive efforts for early return to work.
• 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 statutory limits.
• Oversee and work with outside counsel to provide information and strategic direction as needed for litigation and/or settlement negotiations
• Report to the office on scheduled in-office days to support real-time collaboration with the claims team and supervisor on complex and litigated claims; this in-office presence is an essential function of the role.
• Ability to maintain on-going education credits in a multitude of states. Manage claims across multiple state jurisdictions (currently 18 states handled in house), each with distinct statutory and regulatory requirements.

You own this if...

• 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, California Self Insured Certificate preferred.

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 use good judgment at all times
• Excellent time management and organizational skills
• High level of attention to details while working in a fast-paced environment
• Frequent use of computers, telephones, and other standard office equipment

Physical Requirements

This position involves desk / office work. Employees may need to regularly sit, walk, stand, speak, listen, and do computer keyboarding.

WORK ENVIRONMENT

This position operates in a hybrid work environment, requiring regular in office attendance (currently expected to be 4 days a week with an option to work from home 1 day per week). Regular, reliable attendance at the assigned worksite in accordance with this hybrid schedule is an essential function of this position. Requires the frequent use of a computer, telephone, copier, and other standard office equipment.

Pay Range Details

The pay range(s) below has been provided in compliance with state specific laws. Pay ranges may be different for other locations.

Pay offers are dependent on the location, as well as job-related knowledge, skills, and experience.

$69,000.00 - $110,500.00 Annual

We’ve got you covered…

Benefits

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

This position may be eligible for performance-based incentives/bonuses. Benefits include 401k, medical/vision/dental/life/disability insurance options, PTO accruals, Holidays, and more. Eligibility requirements may apply based on location, job level, classification, and length of employment. Learn more in the Nordstrom Benefits Overview by copying and pasting the following URL into your browser: https://careers.nordstrom.com/pdfs/Ben_Overview_15_Full_Time_ES-US.pdf

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.

For Los Angeles or San Francisco applicants: Nordstrom is required to inform you that we conduct background checks after conditional offer and consider qualified applicants with criminal histories in a manner consistent with legal requirements per Los Angeles, Cal. Muni. Code 189.04 and the San Francisco Fair Chance Ordinance. For additional state and location specific notices, please refer to the Legal Notices document within the FAQ section of the Nordstrom Careers site.

Applicants with disabilities who require assistance or accommodation should contact the nearest Nordstrom location, which can be identified at www.nordstrom.com.

Please be mindful that there may be legal notices and requirements related to this job posting that are specific to your state. Review the Career Site FAQ’s for relevant information and guidelines.

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