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Claims Analyst - Workers Compensation
Optimal Chicago, IL
$81k-104k (estimate)
Full Time | IT Outsourcing & Consulting 3 Months Ago
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Optimal is Hiring a Claims Analyst - Workers Compensation Near Chicago, IL

Position Description:

Primary Workers' Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position with hybrid work schedule to be considered.

Skills Required:

Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.

  • Ability to handle a full case load, with proven ability to handle cases of increased severity.
  • Workers' Compensation Lost Time claim handling experience.
  • Manage claims through well-developed action plans to ensure timely and cost-effective resolutions.
  • Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle claims within designated authority level.
  • Prepare necessary state fillings within statutory limits.
  • Coordinate vendor referrals for additional investigation and/or litigation management.
  • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Manage claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Report claims to the excess carrier.
  • Communicate claim activity and processing with the claimant and the client.
  • Ensure claim files are properly documented and claims coding is correct.
  • Refer cases as appropriate to supervisor and management.

Skills Preferred:

  • Excellent oral and written communication skills.
  • PC literate, including Microsoft Office products.
  • Analytical and interpretive skills.
  • Strong organizational skills.
  • Good interpersonal skills.
  • Excellent negotiation skills.
  • Ability to work in a team environment.

Experience Required:

  • 3-5 years of Illinois Workers' Compensation claims management experience

Education Required:

  • College degree and 3-5 years of Illinois claims management experience or equivalent combination of education and experience preferred.
  • High school diploma and 3-5 years related Illinois claims experience accepted.

Job Summary

JOB TYPE

Full Time

INDUSTRY

IT Outsourcing & Consulting

SALARY

$81k-104k (estimate)

POST DATE

01/20/2024

EXPIRATION DATE

05/14/2024

WEBSITE

optimalsocial.com

HEADQUARTERS

San Francisco, CA

SIZE

25 - 50

INDUSTRY

IT Outsourcing & Consulting

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