Workers' Compensation Claims Analyst
MGM Resorts International · Home
US, NevadaThe SHOW comes alive at MGM Resorts International
Have you ever wondered what it would be like to work in a place full of excitement, diversity, and entertainment? Are you enthusiastic about being a team player in one of the most fascinating industries in the world? At MGM Resorts, we seek individuals like YOU to create unique and show-stopping experiences for our guests.
THE JOB:
The primary purpose of the Workers' Compensation Claims Analyst is to manage the investigation and administration of all Workers' Compensation claims handled by Third-Party Administrators (TPAs), ensuring program excellence and the success of our collaborative team. This role maintains direct, day-to-day oversight of the company’s Nevada claims, serving as the frontline liaison between domestic Nevada property management and TPA adjusters to ensure claims are resolved thoroughly and compliantly. Additionally, the Analyst provides collaborative, escalated oversight and administrative liaison support for claims in Michigan, Ohio, Massachusetts, Maryland, New York, New Jersey, and Mississippi, under the direct guidance and supervision of the Director. The Analyst reviews and audits claim files for accuracy, provides critical financial alerts to the Director on high-impact claims, and utilizes critical thinking to conduct proactive communication with internal and external partners, as well as with injured employees when necessary or as directed by leadership.
THE DAY-TO-DAY:
Manage and serve as the company claim advocate for Worker's Compensation claims administered by TPAs nationwide.
Serve as the primary key contact with the TPAs, MGM department leaders, and the injured worker to ensure timely and appropriate administration of claims.
Supervise TPA administration for quality assurance, appropriate claim management, control of medical management services, and oversight of litigation expenses.
Carryout oversight and audit processes to monitor the TPA's adherence to their Best Practices and agreed upon Special Handling Instructions.
Oversee Worker's Compensation claims the handling of the Companies Nevada, Michigan, Ohio, Massachusetts, Maryland, New York, New Jersey and Mississippi Workers' Compensation claims reviewing notes in TPA Risk Management Systems including, but not limited to, data entry, claim reporting, appropriate medical management, reserving, timely claimant communication, documentation, litigation, settlement negotiations, and return to work protocol.
Works closely with the Director of Worker's Compensation in identifying trends and areas for program improvement.
Conduct and facilitate claim reviews on a quarterly basis with the TPA adjusters to ensure TPA compliance with MGM requirements and quality assurance standards.
Oversight of the TPA adjuster files for proper evidence and a plan for case resolution.
Identify cases that should resolve and work with the adjuster to resolve at the earliest opportunity.
Establishes a cadence of regular interactions with key TPA claims personnel to ensure alignment of expectations and strengthening of the partnership.
Works collaboratively with the TPA claims handlers to develop strategies for cost containment and claim resolution.
Responsible for collaborating with Company Return to Work Specialists and ADA Department to follow corporate guidelines regarding permanent restriction processes.
Provide education and training to departments as needed, aimed to reduce frequency of injuries.
Serve as a resource to the injured employee to assist in navigation of the Work Comp claims process.
Weekly management of Work Comp claims system in order to supply relevant data to OSHA 300 and 301 logs, in coloration with the Safety Department, to ensure compliance with all federal, state, and local reporting requirements.
Remains up to date of worker's compensation regulations, laws and ruling.
Other projects and tasks as necessary and required by the Director of Worker's Compensation, VP of Risk Management, and other Risk Management department leaders.
THE IDEAL CANDIDATE:
Has a High School Diploma or GED
Have 3+ Years of prior relevant experience working for a public company in the State of Nevada
Has a Bachelor's Degree - Preferred
Nevada State Worker's Compensation license - Preferred
Previous experience working in a similar resort setting - Preferred
THE PERKS & BENEFITS:
Wellness incentive programs to help you stay healthy physically and mentally
Access to company hotel, food and beverage, retail, and entertainment discounts as well as discounts with company partners on things like travel, electronics, online shopping, and more
Free parking on and off shift
Health & Income Protection benefits (for eligible employees)
Professional and personal development through programs and networking opportunities as well as volunteer opportunities in the community
VIEW JOB DESCRIPTION:
https://mgmresorts.marketpayjobs.com/ShowJob.aspx?EntityID=2&jobcode=12114
Are you ready to JOIN THE SHOW? Apply today!