Workers' Compensation Indemnity Claims Analyst

Job Description

Salary: $50, 000 - $60,000

Summary:

The New Jersey Workers' Compensation Indemnity Claims Analyst independently manages the investigation, evaluation, and resolution of workers compensation claims in compliance with legal statutes, policy terms, and client-specific instructions. The analyst coordinates medical care, negotiates settlements, and works closely with claimants, clients, attorneys, and medical professionals to achieve timely, cost-effective outcomes. This role also serves as a technical resource and advocate for client claim concerns.

Key Responsibilities:

Promptly investigate assigned indemnity claims from routine to complex with minimal supervision.

Determine compensability in accordance with applicable jurisdictional requirements.

Develop and maintain a resolution plan covering medical, indemnity, litigation, and settlement strategies.

Set and adjust reserves with appropriate documentation.

Identify red flags and escalate potential fraud concerns.

Confirm insurance coverage and self-insured retention amounts

Notify and update excess carriers; request reimbursements as needed.

Identify and pursue subrogation and Second Injury Fund opportunities.

Manage medical treatment, including provider network use and pre-approvals for surgery.

Approve medical bills and calculate/pay indemnity benefits accurately and on time.

Support early return-to-work efforts, including modified duty arrangements.

Negotiate and settle claims within authority and process payments accordingly.

Ensure compliance with N.J. statutes, company best practices, and client protocols.

Communicate clearly and professionally with all parties involved.

Stay current on New Jersey workers compensation laws and relevant case laws.

Requirements:

Associate degree and/or 3+ years of relevant claims experience required; bachelors degree preferred.

Minimum 3 years of workers compensation claims handling experience.

Public entity claims experience a plus.

Strong customer service, organization, and attention to detail.

Proficient in Microsoft Office and industry-related systems.

Excellent written, verbal, analytical, and negotiation skills.

Must maintain required analyst licenses as applicable.

Candidates must be residents of NJ, PA, DE, TX, or FL

Physical Requirements:

Prolonged periods of desk/computer work

remote work

Fully remote