Senior Workers Compensation Claims Analyst

TriNet is a leading provider of comprehensive human resources solutions for small to midsize businesses (SMBs). We enhance business productivity by enabling our clients to outsource their HR function to one strategic partner and allowing them to focus on operating and growing their core businesses. Our full-service HR solutions include features such as payroll processing human capital consulting employment law compliance and employee benefits including health insurance retirement plans and workers compensation insurance.

TriNet has a nationwide presence and an experienced executive team. Our stock is publicly traded on the NYSE under the ticker symbol TNET. If youre passionate about innovation and making an impact on the large SMB market come join us as we power our clients business success with extraordinary HR.

Dont meet every single requirement Studies have shown that many potential applicants discourage themselves from applying to jobs unless they meet every single requirement. TriNet always strives to hire the most qualified candidate for a particular role ensuring we deliver outstanding results for our small and medium-size customers. So if youre excited about this role but your past experience doesnt align perfectly with every single qualification in the job description nobodys perfect and we encourage you to apply. You may just be the right candidate for this or other roles.

A Brief Overview
The Sr. Claims Analyst is responsible for oversight & monitoring activities for assigned Workers Compensation claims in multiple jurisdictions. This role will manage claims for large national clients mainly by working directly with the TPA and assigned vendors. The position is responsible for financial monitoring of claims data integrity managing claims costs and outcomes while providing excellent customer service to our clients and internal colleagues.

What you will do

• Acts as oversight by performing a thorough review for proper claim strategy (best practice claims management) and reserving of reported WC Claims.

• Communicate with the TPA adjusters on a daily basis to develop strategies and document a clear plan of action to closure on all assigned claims. Ensure TPA is employing proper techniques to mitigate claims expense including but not limited to: medical care is consistent and minimizes overutilization defense attorneys are using tactics to reduce litigation expense and all other vendors are properly utilized to avoid costs to the claim without adversely affecting the claim outcome.

• Act as Subject Matter Expert for WC Claims department and other internal TriNet departments and mentor Claim Analysts and WC Claims Associates.

• Manage complex high-profile clients as assigned and conduct legal and claim reviews as necessary.

• Identify and lead projects and initiatives within the department for process improvement including staying abreast of the changing workers compensation statues.

• Review and approve all requests legal referrals proper investigation and additional claims expense used to mitigate the cost of claims for the client.

• Engage all departments when retention efforts are necessary including Senior Management.

• Participate in all claim reviews with claim management team as needed and escalate concerns regarding claim quality and outcomes

• Document client conversations using SalesForce/Origami as client relationship software.

• Performs other duties as assigned

• Complies with all policies and standards

Education Qualifications

• Bachelors Degree or equivalent experience preferred

Experience Qualifications

• Typically 5 years of claims adjusting experience required

Skills and Abilities

• Excellent verbal and written communication skills proper use of grammar and available tools to create presentations to clients.

• Multi-jurisdictional knowledge

• Strong communication skills with employees at all levels of the organization

• Strong knowledge and understanding of both state and federal employment laws

• Excellent interpersonal skills

• Excellent presentation and facilitation skills

• A demonstrated commitment to high professional ethical standards and a diverse workplace

• Ability to adapt to a fast paced continually changing business and work environment while managing multiple priorities

• Proficient in Microsoft Office Suite specifically PowerPoint and Excel.

• Knowledge of (RMIS) Risk Management Information Systems and SalesForce

Licenses and Certifications

• AIC SCLA claims certification Upon Hire preferred

Travel Requirements
Minimal

Work Environment

Working hours to align with Mountain Standard Time (estimated 10am-6pm EST)

Work in clean pleasant and comfortable office or home setting. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable persons with disabilities to perform the essential functions.

The preferred location for this role is Atlanta GA and the salary range for this location is $69200.00 to $138500.00. All qualified external applicants will be considered for an in-office role based in Atlanta. All qualified internal candidates are encouraged to apply and consider relocation to Atlanta and may be considered for remote hire at the companys discretion. The candidates final salary offer will be based on the candidates skills education work location and experience.

A candidates compensation may also include bonuses consistent with TriNets corporate bonus plan.

Additionally subject to applicable eligibility requirements TriNet offers permanent full-time employees a variety of benefits including medical dental and vision plans life and disability insurance a 401(K) savings plan an employee stock purchase plan eleven (11) Company observed holidays PTO and a comprehensive leave program. Please click the following link for detailed information about our benefits offerings: Note: TriNet reserves the right to change or modify job duties and assignments at any time. The above job description is not all encompassing. Position functions and qualifications may vary depending on business necessity.

TriNet is an Equal Opportunity Employer and does not discriminate against applicants based on race religion color disability medical condition legally protected genetic information national origin gender sexual orientation marital status gender identity or expression sex (including pregnancy childbirth or related medical conditions) age veteran status or other legally protected characteristics. Any applicant with a mental or physical disability who requires an accommodation during the application process should contact to request such an accommodation.