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Risk Management Analyst – Workers’ Compensation
Location
Rhode Island
Posted
26 days ago
Salary
$43.9K - $102.1K / year
Seniority
Senior
Job Description
Risk Management Analyst – Workers’ Compensation
CVS Health
• Proactively oversee and manage TPA performance through reporting, auditing, and claim reviews. • Oversee the daily work product of multiple lost time and medical-only workers’ compensation adjusters in your assigned territory, completing monthly audits and case reviews. • Actively participate in internal claim reviews and legal roundtables. • Ensure that reserves and settlement authorities are reviewed and granted in compliance with our internal processes. • Review and interpret medical reports, expert reports, legal and various supporting claim documents. • Analyze case and internal investigative materials to determine legal liability and that reserves are set for the known exposure.
Job Requirements
- 1-3 years’ experience handling Lost Time workers’ compensation claims and/or equivalent experience with TPA oversight.
- Experience in Microsoft Office applications with a proven ability to learn new software programs and systems as required.
- Insurance designations is a plus.
- California workers’ compensation claims handling experience or jurisdictional knowledge a plus.
- Ability to interact and navigate situations with both internal and external partners.
- Ability to work independently and in an environment requiring teamwork and collaboration.
- Ability to train less experienced TPA adjusters on implementation of claim best practices.
- Demonstrate excellent analytical, organizational, written, and communication skills, with the ability to generate concise claim outlines that capture and detail critical case components.
- Exhibit proven time management skills and the ability to oversee a high volume of cases effectively.
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- comprehensive benefits package
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