Atrium Health · 1 day ago
Workers Compensation Claims Analyst
Charlotte, NC
Full-time
Hybrid
Entry, Mid Level
$30.15/hr - $45.25/hr
2+ years expAdvocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. The Workers Compensation Claims Analyst is responsible for managing claims, adjudicating medical only claims, and working closely with case managers, attorneys, and vendors to negotiate claim settlements and support departmental goals.
Health CareHospital
Responsibilities
Must possess analytical skills and be able to work with a sense of urgency and accuracy. Must be able to adhere to multiple state workers’ compensation rules, regulations, and laws
Must be able to complete appropriate contacts within 24 hours of assignment, establish and maintain appropriate diary for follow-up, evaluates and determines compensability of workers’ compensation claims within the statutory period for multiple jurisdictions
Must be able to be responsible for monitoring and controlling costs, timely documentation of the electronic claim file, claim outcome, timely reserving of files, managing subrogation and litigation, filing appropriate forms and payment of all benefits due within statutory periods and coordinates light duty as needed
Must function as a resource to the injured teammates, leaders, and others with an interest in the claim
Must be able to communicate claim status with the injured teammate and other parties, as necessary
Must be able to develop action plans and strategies for prompt payment/denial of claims bringing them to a timely conclusion while providing all appropriate information. Must be able to monitor and report appropriate claims to excess carriers
Must be able to determine what treatment is appropriate and causally related to the compensable injury and redirect treatment to network physicians as appropriate. Must be able to promptly authorize and approve related expenses of the claim
Must be able to maintain strict confidentiality of information at all times of a sensitive nature and/or protected under state and federal law
Must be able to develop and maintain professional customer relationships. Must be able to provide education as needed and serve as a mentor to other adjusters and stakeholders
Must be able to provide additional support for additional projects and duties as assigned
Qualification
Required
Adjusters license for assigned jurisdiction as required by specific jurisdiction as applicable
Bachelor's degree required or a combination of education and related experience
2-5+ years' experience managing progressively difficult Workers Compensation lost time claims
Must possess analytical skills and be able to work with a sense of urgency and accuracy
Must be able to adhere to multiple state workers' compensation rules, regulations, and laws
Must be able to complete appropriate contacts within 24 hours of assignment, establish and maintain appropriate diary for follow-up, evaluates and determines compensability of workers' compensation claims within the statutory period for multiple jurisdictions
Must be able to be responsible for monitoring and controlling costs, timely documentation of the electronic claim file, claim outcome, timely reserving of files, managing subrogation and litigation, filing appropriate forms and payment of all benefits due within statutory periods and coordinates light duty as needed
Must function as a resource to the injured teammates, leaders, and others with an interest in the claim
Must be able to communicate claim status with the injured teammate and other parties, as necessary
Must be able to develop action plans and strategies for prompt payment/denial of claims bringing them to a timely conclusion while providing all appropriate information
Must be able to monitor and report appropriate claims to excess carriers
Must be able to determine what treatment is appropriate and causally related to the compensable injury and redirect treatment to network physicians as appropriate
Must be able to promptly authorize and approve related expenses of the claim
Must be able to maintain strict confidentiality of information at all times of a sensitive nature and/or protected under state and federal law
Must be able to develop and maintain professional customer relationships
Must be able to provide education as needed and serve as a mentor to other adjusters and stakeholders
Must be able to provide additional support for additional projects and duties as assigned
Must be competent in workers' compensation rules, regulations, and laws for multiple jurisdictions
Must work with a sense of urgency and accuracy
Evaluates and determines compensability of workers' compensation claims within the statutory limits for multiple jurisdictions
Must be able to work independently as well as part of a team
Access to protected Health Information (PHI) to the extent of information necessary to do the job. Information shared only on a need-to-know basis
Preferred
Associates in Claims designation preferred
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
Company
Atrium Health
Atrium Health, part of Advocate Health, is redefining how, when and where care is delivered.
Founded in 2007Charlotte, North Carolina, USA
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$6MKey Investors
Isabella Santos Foundation
2018-04-11Grant· $5M
2017-02-23Grant· $1M
Leadership Team
Dick Baker, IOM, CFRM
Executive Director/CEO, The HealthCare Foundation of Cleveland County
Eugene A. Woods
President and CEO
Recent News
Charlotte Business Journal
2025-02-01
Charlotte Business Journal
2025-02-01
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