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County of Ventura · 8 hours ago

Workers' Compensation Risk Analyst

Ventura, CA

Full-time

Onsite

Mid, Senior Level

2+ years exp

The County of Ventura is seeking a Workers' Compensation Risk Analyst to oversee and monitor the administration of workers' compensation benefits. This role involves recommending and implementing policies and procedures, assisting in investigations for disability retirement, and ensuring compliance with laws and regulations.

Association

Responsibilities

Audits and oversees TPA claims staff to ensure adherence to laws, regulations, contractual obligations, and claims management best practices

Assists the TPA to facilitate review and decision-making on claims

Independently rates permanent disability to evaluate settlement recommendations of TPA claims staff and defense counsel

Acts as ombudsman between agencies, claimants, TPA, insurance carriers, and regulatory agencies

Conducts periodic reviews and audits with County agencies, TPA staff, and insurance carriers

Oversees the provision of benefits and compensation by the County, TPA, and insurance carriers

Assists TPA, defense counsel, and agencies in the investigation and litigation management of workers’ compensation and disability retirement cases

Performs and coordinates investigations, audits, and evaluations of incidents, complaints, and claims

Prepares reports for agency directors and managers

Monitors TPA and insurance carrier claim systems for accuracy

Reviews, revises, designs, coordinates, implements, and administers policies and procedures

Assembles, analyzes, validates, and correlates loss information from a variety of sources, including loss runs from insurance carriers, County resources, and agency records

Provides information and training to County personnel

Assists direct manager and senior leaders within Risk Management, as required

Qualification

Workers' compensation claims administrationRating permanent disabilitySelf-insurance certificationAnalytical abilitiesMicrosoft ExcelMicrosoft WordCommunication skillsTeam collaborationAttention to detailProject management

Required

Bachelor's degree in a related field (e.g., business administration, public administration, legal studies, occupational safety, industrial relations, or human resources management)

Two (2) years' experience handling workers' compensation claims, including experience with claim evaluation, management, or adjustment, obtained in insurance companies, TPAs, self-insured organizations, government agencies, or other relevant employers

Basic proficiency in Microsoft Excel and Word

Experience rating permanent disability in California

Willing and able to occasionally travel within the County and infrequently travel outside of the County

Preferred

Four (4) or more years' experience as a workers' compensation claims examiner or adjustor for an insurance carrier, third-party administrator, or self-administered self-insured entity

Possession of a self-insured workers' compensation claims administration certification

Certified Workers' Compensation Claims Professional (W.C.C.P.) or equivalent

Experience in developing and utilizing information technology solutions and analytical tools for risk management issues

Familiarity with Labor Code provisions (such as 4850 and 3212) specific to safety members

Experience developing and utilizing information technology solutions and analytical tools used for risk management issues

Benefits

Educational Incentive for completion of: 2.5% for an associate degree, 3.5% for a bachelor's degree, or 5% for a master's degree.

Annual Leave Redemption: The option to cash out up to 100 hours of Annual Leave accrued per year.

Deferred Compensation: Section 457 Plan and/or 401(k) Shared Savings Plan with up to a 3% match on your 401(k) contributions.

Health Plans: You are afforded a flexible credit allowance of up to $25,558 annually for purchasing medical, dental, and/or vision insurance from a group of authorized plans.

Flexible Spending Accounts: Pre-tax benefit towards eligible medical, dental, and vision care expenses.

Pension Plan: Participation in the County's defined benefit plan, which has reciprocity with CalPERS.

Holidays: 11 paid days per year, which include a scheduled floating holiday.