Claims Compliance Analyst - Workers' Compensation

We are seeking a Claims Compliance Analyst to join our Claims team and oversee regulatory compliance activities across the Workers’ Compensation line of business.

The ideal candidate will have a strong understanding of Workers’ Compensation claim regulations and demonstrate the ability to navigate compliance requirements. This role requires a proactive professional who can manage multiple projects simultaneously, including direct interaction with state regulatory authorities.

Job Responsibilities

• Monitor and enforce compliance with workers' compensation statutes, regulations, and internal procedures.
• Review and analyze claim filings from insurance carriers and self-insured entities to ensure timely and accurate submissions.
• Identify and address discrepancies or non-compliance issues, including initiating corrective actions or fines.
• Collaborate with IT or vendor teams to support system enhancements related to compliance tracking.
• Provide input on system requirements for workers' compensation claims handling platforms.
• Support in audit, and compliance education initiatives
• Stay current with changes in workers’ compensation laws and regulations.
• Develop and deliver claims compliance training and educational materials for claims staff related to workers' compensation regulatory changes, emerging trends, identified compliance risks, and internal best practices.
• Coordinate and facilitate state-specific regulatory training initiatives with internal and external stakeholders.
• Review and validate workers' compensation claims systems and workflows to ensure compliance-related data elements, forms, notices, and calculations remain current and aligned with state requirements.