WORKERS' COMPENSATION ANALYST

Job Overview Metro’s mission is to provide a world‑class transportation system that enhances the quality of life for all who live, work, and play within LA County. The Workers Compensation Analyst evaluates claims in accordance with the California Labor Code and WCAB procedures, ensures timely benefits, accurate documentation, and compliance with state‑mandated requirements. This role works closely with stakeholders to deliver timely benefits, maintain audit‑ready files, and support effective return‑to‑work outcomes. Duties Conduct journey‑level investigations upon receipt of new claims Review and respond to all incoming legal and medical mail in a timely manner in accordance with California Labor Code regulations Audit claim files to ensure all benefits have been paid appropriately Provide timely and quality customer service to all Metro staff and outside providers Maintain close working contact with injured employees and division personnel Maintain claim files on an effective diary system Meet with division personnel quarterly to review open Workers’ Compensation cases Work closely with legal to strategize on appropriate handling of claims Minimum Qualifications Education: Bachelor’s Degree in Business Administration, Human Resources, or a related field Experience: One year of relevant experience examining California Workers’ Compensation indemnity claims or related industry experience Certification: Valid California Class C Driver License or alternative transportation method Certifications & Licenses Insurance Education Association Certificate and California Workers’ Compensation Self‑Insured Certificate preferred Prior employers’ designation Certificate required in claims handling Preferred Qualifications Experience applying workers’ compensation labor code laws when providing benefits or denying a claim Experience reviewing medical reports to explain timelines for the provision of benefits Experience conducting full‑cycle workers’ compensation claims Experience monitoring and/or processing provisions of workers’ compensation benefits, time limitations, and benefit letters Experience reviewing medical reports and Whole Person Impairment calculations and rating Maximum Medical Improvement reports Essential Knowledge Theories, principles, and practices of workers’ compensation claims administration California State Labor Code and applicable laws, rules, and regulations governing workers’ compensation American Medical Association Guidelines Permanent Disability Ratings Applicable business software applications Skill Performing professional workers’ compensation claims administration work Calculating wages Analyzing situations, identifying problems and issues, and recommending solutions Exercising sound judgment when faced with complex issues Communicating effectively verbally and in writing Interacting professionally with various levels of Metro employees and outside representatives Conducting and reporting outcomes of roundtable sessions to discuss cases Ability To Read and interpret legal reports Review and rate medical reports Work with legal representatives to resolve matters or cases Work aggressively to bring cases to resolution without legal actions Handle work assignments and meet time constraints on a strict diary system to ensure deadlines are met Organize and prioritize work Compile, analyze, and prepare comprehensive management reports Use good judgment when handling highly confidential information Understand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreements Travel to off‑site locations Read, write, speak, and understand English Special Conditions This job specification is not to be construed as an exhaustive list of duties, responsibilities, or requirements The physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions This classification is at‑will and the incumbent serves at the pleasure of the hiring authority when classified as an Intermittent, Emergency, Annuitant, or Temporary employee, is assigned to the Office of Inspector General (OIG) or Board Clerk’s Office, and/or reporting directly to the LACMTA Board of Directors Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out Working Conditions Typical office situation Close exposure to computer monitors and video screens Physical Effort Required Sitting at a desk or table Operate a telephone or other telecommunications device and communicate through the medium Type and use a keyboard and mouse to perform necessary computer‑based functions Communicating through speech in the English language required Equity & Diversity Metro is an Equal Opportunity Employer and does not discriminate on the basis of race, color, creed, ancestry, national origin, gender, marital status, sexual orientation, religion, age, veteran status, or disability. Learn more about Metro’s Equal Employment Opportunity Program. Metro does not deny participation in the application process to anyone with prior justice system involvement, in line with Fair Chance hiring practices. Selection Procedure Applicants who best meet job‑related qualifications will be invited to participate in the examination process that may consist of any combination of written, performance, or oral appraisal to further evaluate job‑related experience, knowledge, skills, and abilities. #J-18808-Ljbffr Los Angeles Metro