Workers Compensation Claims Analyst
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Job Description
Workers Compensation Claims Analyst handling medical only claims and limited lost time claims for Advocate Health. Collaborating with case managers, attorneys, and vendors while adhering to regulatory compliance requirements.
Responsibilities:
- Manage claims within organizational standards and best practices
- Responsible for the adjudication of medical only claims and limited lost time workers' compensation claims
- Work closely with case managers, attorneys, and vendors
- Manage subrogation liens and negotiate claim settlements to achieve the best possible outcome
- Complete appropriate contacts within 24 hours of assignment
- Establish and maintain appropriate diary for follow-up
- Evaluate and determine compensability of workers’ compensation claims
- Monitor and control costs, timely documentation of the electronic claim file
- Communicate claim status with the injured teammate and other parties as necessary
- Develop action plans and strategies for prompt payment/denial of claims
Requirements:
- Bachelor's degree required or a combination of education and related experience
- Adjusters license for assigned jurisdiction as required by specific jurisdiction as applicable
- 2-5+ years’ experience managing progressively difficult Workers Compensation lost time claims
- Proficiency in MS Office
- Preferred: Associates in Claims designation
- Experience with self-insured/self-administered organizations
- Experience with Riskconnect and/or Origami
Benefits:
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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