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Claims Management Analyst
2 months ago
Position Overview:
This role is pivotal in ensuring the accuracy and compliance of incoming claims documentation in accordance with relevant workers' compensation regulations, statutes, and legal precedents.
The State of Arizona promotes a flexible work environment that supports remote work opportunities, contingent upon departmental needs and consistent performance metrics.
Our commitment to a culture of trust and autonomy allows many employees to engage in the State's Remote Work Program, facilitating work from various locations within Arizona.
Key Responsibilities:
Essential duties include, but are not limited to:
- Conducting thorough analyses of submitted claims forms to ensure compliance and issuing appropriate determinations.
- Auditing claims managed by insurance providers, self-insured entities, and third-party administrators.
- Reviewing notifications and accompanying medical documentation to confirm alignment with current claims status and award calculations.
- Responding to inquiries from injured workers, legal representatives, claim adjusters, medical professionals, and the public.
- Linking incomplete documents to existing claims by researching the Claims database and creating new claim files as necessary.
- Providing support for data entry, resolving discrepancies, and assisting with claims management tasks as required.
- Participating in the Arizona Management System (AMS) and daily team meetings.
- Attending professional development sessions, workshops, and training programs.
Knowledge, Skills & Abilities:
Successful candidates will possess:
- Foundational knowledge of workers' compensation claims management laws and regulations.
- Basic understanding of medical terminology.
- Proficiency in Microsoft Office Suite and Google Workspace.
- Strong communication skills, both verbal and written, for effective dispute resolution.
- Analytical skills for reviewing insurance, medical, and legal documents.
- Critical thinking and time management abilities.
- Customer service orientation and organizational skills.
Preferred Qualifications:
The ideal candidate will hold a claims adjusting license or relevant certification in workers' compensation.
Pre-Employment Requirements:
All new hires must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Benefits:
The Arizona Department of Administration offers a comprehensive benefits package, including:
- Sick leave and vacation with paid holidays.
- Health and dental insurance.
- Retirement plans and life insurance.
- Optional benefits such as short-term disability insurance and deferred compensation plans.
This position provides the flexibility of a full-time or part-time remote work schedule, contributing to a better work-life balance and increased job satisfaction.
Retirement:
Employees are eligible to participate in the state employee health and disability insurance plan and must enroll in the Arizona State Retirement System (ASRS), with employer-matched contributions.
