FreshRemote.Work

Intermediate Workers Compensation Analyst - (Remote -California Only)

Costa Mesa CA

Job Description

The Workers Compensation Risk Analyst 3 will be responsible for managing moderately complex claims, including high exposure and litigated claims. This is an intermediate role on the team, not a senior role. 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.

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.
  • 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.

You own this if you have:

  • At least 2 years direct workers compensation experience (actually working claims)
  • Experience with Indemnity claims (not just medical only)
  • Adjuster training hours for the past 2 years (must be recent -(state requires 30 hours)
  • Must be located in California.
  • Strong Customer service skills a must
  • Good understanding of workers’ compensation laws and regulations as well as workers’ compensation claim principles and application.
  •  IEA OR California Self Insured huge plus
  • Must have a high attention to detail while working in a fast-paced environment
  • Must have computer experience and be good with MS Office Suite

We’ve got you covered…

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.

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

© 2022 Nordstrom, Inc  

Current Nordstrom employees: To apply, log into Workday, click the Careers button and then click Find Jobs.

Pay Range Details

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

California: $66,560 - $119,000 Annually

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Job Profile

Restrictions

CA Remote only for California residents

Benefits/Perks

Dental Disability EAP resources Employee discount Life Insurance Medical Merchandise Discount Paid Time Off Retirement Vision

Tasks
  • Calculate reserves
  • Investigate claims
  • Manage claims
  • Negotiate settlements
  • Prepare state filings
  • Review medical bills
Skills

Claims management Customer service Investigation Litigation Medical Billing MS Office Suite Negotiation Regulatory Compliance Subrogation Workers Compensation

Experience

2 years

Timezones

UTC-8