SENIOR WORKERS' COMPENSATION ANALYST (RISK MANAGEMENT)

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. Job Description Performs senior analyst‑level workers’ compensation functions in accordance with the California Labor Code, mentors lower level staff, and works with management and division personnel to enhance the Transitional Duty Program (TDP). Key Responsibilities Conduct senior analyst‑level investigations upon receipt of new claims Assist employees who have been injured on the job and process benefits due to injured employees Handle issues and problems regarding injured workers who have filed claims Process medical bills and liens accumulated during an injured employee claim process Review and respond daily to all incoming legal and medical mail in a timely manner in accordance with California Labor Code regulations Handle claim files efficiently to ensure all benefits have been paid timely and appropriately Provide quality customer service to injured employees, division personnel, and providers Maintain claim files on an effective diary system to aggressively handle claims and ensure timely responses Work closely with legal to strategize on plans of action for appropriate resolution of claims Mentor and train lower level employees Provide a high quantity and quality of work in accordance with departmental policies and procedures and the California Labor Code Regulations and Requirements Prepare files for presentation to division personnel as required Minimum Qualifications Education: Bachelor’s Degree in Business or a related field Experience: Three years of relevant experience handling, analyzing, and resolving workers’ compensation claims and a caseload of varying types of employers, including California workers’ compensation laws experience Certification: Valid California Class C DriverLicense or ability to use alternative transportation when needed Preferred certifications: California Workers’ Compensation Claims Administration (WCCA) Certificate; Prior employer’s Designation Certificate; California Self‑Insurers Administration Certificate Preferred Qualifications Experience applying Workers’ Compensation labor code laws when providing benefits or denying a claim Experience in reading and comprehending 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 frames and benefit letters Experience reviewing medical reports, calculating Whole Person Impairment, rating Maximum Medical Improvement reports Essential Knowledge Theories, principles and practices of claims administration Applicable local, state and federal laws, rules, regulations and guidelines governing workers’ compensation, disability and vocational rehabilitation State Labor Code laws Strategies and procedures for case settlements Research and report preparation Applicable business software applications Skills Performing professional workers’ compensation claims administration work Calculating wages Reviewing and rating medical reports Analyzing situations, identifying problems and issues, and recommending solutions Working with legal representatives to resolve matters or cases Working aggressively to bring cases to resolution without legal actions Preparing comprehensive reports and correspondence Communicating effectively both orally and in writing Operating personal computers and office equipment Abilities Organize and prioritize work Handle work assignments on a strict diary system to ensure deadlines are met timely Meet time constraints and deadlines Use good judgment when handling highly confidential material and information Follow both oral and written instructions Understand, interpret and apply laws, rules, regulations, policies, procedures, guidelines, contracts, budgets and labor/management agreements Compile and analyze data, prepare and report statistical information Interact professionally with various levels of employees and outside representatives 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 as an Intermittent, Emergency, Annuitant or Temporary employee, is assigned to the Office of Inspector General (OIG) or Board Clerk’s Office, and/or reports 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 screen Physical Effort Required Sitting at a desk or table Operate a telephone or other telecommunications device Type and use a keyboard and mouse to perform necessary computer‑based functions Communicating through speech in the English language 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. Metro does not deny participation in the application process to anyone with prior justice system involvement, in line with Fair Chance hiring practices. #J-18808-Ljbffr