Claims & Risk Analyst
Core
Manage workers' compensation claims lifecycle from intake to resolution, including data analysis, reporting, and coordination with TPAs and carriers.
Role type
Claims & Risk Analyst (Workers' Compensation)
Builds
Claims management workflows, dashboards, and insurance program administration
Domain
Insurance / Risk Management / Workers' Compensation
Deliverable
dashboards & analysis
Required skills
Workers' compensation claims management, claim intake processing, data analysis, report compilation, trend identification, return-to-work tracking, subrogation support, insurance program administration, cross-functional collaboration
Preferred skills
Power BI, RMIS, ARM, CPCU, CRM, AIC designations
Technologies
Excel, Power BI, RMIS
Responsibilities
Manage claim intake end-to-end including FNOL and severity assignment; Monitor claims lifecycle and coordinate with adjusters for timely progression; Prepare bi-weekly claim reviews and maintain TPA performance metrics; Build and validate dashboards for claims trends and KPIs; Analyze data to identify emerging risks and root causes; Track Return-to-Work progression and compliance data; Support subrogation and recovery efforts; Assist with insurance program administration and renewal support; Partner with TPAs on reserve adequacy and claim strategy.
Seniority
Mid-level, hands-on IC
