Workers' Compensation Claims Analyst jobs in United States
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Advocate Health Care · 20 hours ago

Workers' Compensation Claims Analyst

Advocate Health Care is seeking a Workers' Compensation Claims Analyst to manage and evaluate claims while adhering to state regulations. The role involves monitoring costs, maintaining documentation, and communicating with injured teammates to ensure timely resolution of claims.

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H1B Sponsor Likelynote

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

Analytical skillsWorkers' compensation knowledgeAdjusters licenseCustomer relationship managementCommunication skills

Required

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 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
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 claims 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
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
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 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

Preferred

Associates in Claims designation preferred

Company

Advocate Health Care

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Advocate Health Care is an integrated healthcare delivery system based in Illinois, United States.

H1B Sponsorship

Advocate Health Care has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (26)
2024 (9)
2023 (6)
2022 (16)
2021 (8)
2020 (7)

Funding

Current Stage
Late Stage
Total Funding
$18M
2013-10-03Series Unknown· $18M

Leadership Team

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Barbara Hancock
Executive Assistant to the President and Chief Operating Officer
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David Rich
Clinical Practice Partner
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Company data provided by crunchbase