Note: The job is a remote job and is open to candidates in USA. DaVita Kidney Care is a leading provider of kidney care services, and they are seeking an Analyst for Workers' Compensation. The role involves overseeing Workers' Compensation claims, serving as a liaison among various stakeholders, and managing claims resolution activities.
Responsibilities
- Evaluate claims to determine potential exposure; make recommendations concerning the value of the claim; oversee litigation and assist in the negotiation of settlements
- Escalate issues as appropriate for prompt and effective resolution
- Proactively oversee the Worker’s Compensation claims management activities in assigned territories and resolve problems of varying scope and complexity in accordance with state statutes
- Evaluate high exposure Workers’ Compensation claims for settlement and appropriateness of established reserves
- Attend claims audits and reviews; ensure claims are postured for expedited resolution
- Provide daily assistance to DaVita’s management staff, teammates, claims adjusters, insurers, and defense counsel by answering claims-related questions or concerns in the administration and management of claims, and other claims matters
- Facilitate and coordinate teammate return-to-work by working with DaVita management, claims adjusters, and nurse case managers
- Analyze claims data to identify needed loss control interventions and assist with the development of appropriate loss prevention programs as requested
- Provide training and education to facilities on Workers’ Compensation processes and procedures as needed or requested
- Coordinate the handling of Workers’ Compensation subpoenas in an expeditious manner
- Provide reporting and analysis on key metrics related to assigned territory(ies), including analytics on projected and/or established medical provider networks
- Escalate exceptions, outliers, or circumstances that are out-of-norm to Corporate Claims Manager as they occur and seek guidance in resolutions
- Participate in meetings, presentations, and special projects, as necessary
- Other duties and responsibilities as assigned including but not limited to:
- Attend team meetings, phone conferences, and training sessions
- Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
- Flexible schedule and ability to travel required
- Travel required: up to 10%
Skills
- Bachelor's degree in related area highly preferred
- Minimum of three years' experience managing and/or handling Workers' Compensation claims required
- Intermediate computer skills and proficiency in MS Excel, Word, PowerPoint, and Outlook required
- High school diploma or equivalent required
- Basic computer skills and proficiency in MS Word, Excel, and Outlook required
- Workers' Compensation certification preferred; certification or experience in multiple jurisdictions preferred including but not limited to state mandated certificates such as WCCP, WCCA, etc
- Minimum of three (3) years' healthcare reimbursement experience preferred; experience with admissions, billing, and collections preferred
- Demonstrated knowledge of insurance rules, regulations and Coordination of Benefits for federal, state, and managed care payors in multiple states preferred
Benefits
- Medical, dental, vision, 401(k) match, paid time off, PTO cash out
- Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
- DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.
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