WORKERS' COMPENSATION ANALYST (RISK MANAGEMENT)

Metro’s mission is to provide a world-class transportation system that enhances the quality of life for all who live, work, and play within LA County.

Description

Performs journey-level workers' compensation functions in accordance with the California Labor Code and assists employees with work-related injuries return to work and assume their customary duties or to Transitional Duty.
The Workers' Compensation Analyst position is fast-paced and detail-oriented. Responsibilities include reviewing incoming medical bills, reports, legal correspondence, and processing Requests for Authorization in a timely manner. The role also involves managing incoming calls and emails, ensuring timely issuance of benefit payments, and generating appropriate benefit letters. Additionally, the position requires preparation and organization for file reviews.

Recruitment Timelines : Interviews are projected to be scheduled for the week of August 25th, 2025. These dates are subject to change. We encourage you to monitor your governmentjobs.com profile and emails for the latest updates.

Examples of Duties

• Conducts journey-level investigations upon receipt of new claims

• Reviews and responds to all incoming legal and medical mail on a timely manner in accordance with California Labor Code regulations

• Audits claim files to ensure all benefits have been paid appropriately

• Provides timely and quality customer service to all Metro staff as well as outside providers

• Maintains close working contact with injured employees and division personnel

• Maintains claim files on an effective diary system

• Meets with division personnel on a quarterly basis to review open Workers' Compensation cases

• Works closely with legal to strategize on appropriate handling of claims

• Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out
  
  May be required to perform other related job duties
  

Minimum Qualifications

A combination of education and/or experience that provides the required knowledge, skills, and abilities to perform the essential functions of the position. Additional experience, as outlined below, may be substituted for required education on a year-for-year basis. A typical combination includes:

Education

• Bachelor's Degree in Business Administration, Human Resources, or a related field

Experience

• One year of relevant experience examining California Workers' Compensation indemnity claims or related experience in the workers' compensation industry

Certifications/Licenses/Special Requirements

• A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions
• Insurance Education Association Certificate and California Workers' Compensation Self-Insured Certificate preferred
• Prior employers' designation Certificate required in claims handling

Preferred Qualifications

Preferred Qualifications (PQs) are used to identify relevant knowledge, skills, and abilities (KSAs) as determined by business necessity. These criteria are considered preferred qualifications and are not intended to serve as minimum requirements for the position. PQs will help support selection decisions throughout the recruitment. In addition, applicants who possess these PQs will not automatically be selected.

The following are the preferred qualifications:

• Experience applying workers' compensation labor code laws when providing benefits or denying a claim
• Experience reading medical reports to explain timelines for the provision of benefits
• Experience conducting full-cycle workers' compensation claims
• Experience monitoring and/or processing provisions of workers compensation benefits, time limitations, and benefit letters
• Experience reviewing medical reports and Whole Person Impairment calculations and rating Maximum Medical Improvement reports

Essential Knowledge

Knowledge of (defined as a learned body of information that is required for and applied in the performance of job tasks)

• Theories, principles, and practices of workers' compensation claims administration
• California State Labor Code and other applicable laws, rules, and regulations governing workers' compensation
• American Medical Association Guidelines
• Permanent Disability Ratings
• Applicable business software applications

Skill in (defined as the proficient manual, verbal, or mental utilization of data, people, or things)

• Performing professional workers' compensation claims administration work
• Calculating wages
• Analyzing situations, identifying problems and issues, and recommending solutions
• Exercising sound judgment when faced with complex issues
• Communicating effectively verbally and in writing
• Interacting professionally with various levels of Metro employees and outside representatives
• Conducting and reporting outcomes of roundtable sessions to discuss cases

Ability to (defined as a present competence to perform an observable behavior or produce an observable result)

• Read and interpret legal reports
• Review and rate medical reports
• Work with legal representatives to resolve matters or cases
• Work aggressively to bring cases to resolution without legal actions
• Handle work assignments and meet time constraints on a strict diary system to ensure deadlines are met
• Organize and prioritize work
• Compile, analyze, and prepare comprehensive management reports
• Use good judgment when handling highly confidential information
• Understand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreements
• Travel to offsite locations
• Read, write, speak, and understand English

Special Conditions

The physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job. Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions.

Working Conditions

• Typical office situation
• Close exposure to computer monitors and video screen

Physical Effort Required

• Sitting at a desk or table
• Operate a telephone or other telecommunications device and communicate through the medium
• Type and use a keyboard and mouse to perform necessary computer-based functions
• Communicating through speech in the English language required

NW

Metro is an Equal Opportunity Employer and does not discriminate on the basis of race, color, creed, ancestry, national origin, gender, marital status, sexual orientation, religion, age, veteran status, or disability. Learn more about Metro’s Equal Employment Opportunity Program . Metro does not deny participation in the application process to anyone with prior justice system involvement, in line with Fair Chance hiring practices.

Selection Procedure

Applicants who best meet job-related qualifications will be invited to participate in the examination process that may consist of any combination of written, performance, or oral appraisal to further evaluate job-related experience, knowledge, skills and abilities.

Application Procedure

To apply, visit Metro's website at www.metro.net and complete an online Employment Application.
Computers are available to complete online Employment Applications at the following Metro locations:

METRO Headquarters, Employment Office
One Gateway Plaza
Los Angeles, CA 90012
Open: Monday through Friday, 8am-4pm
(Closed Sat & Sun)

Metro Talent Hub
8501 S. Evermont Place
Los Angeles, CA 90044
Open: Monday through Friday, 9am-5pm
(Closed Sat & Sun)

East Los Angeles Customer Center
4501 B Whittier Blvd
Los Angeles, CA 90022
Open: Tuesday through Saturday, 10am to 6pm
(Closed Sun & Mon)

Wilshire/Vermont Customer Center
3183 Wilshire Blvd, Ste 174
Los Angeles, CA 90010
Open: Monday through Friday, 10am-6pm
(Closed Sat & Sun)

Rosa Parks Customer Center
Willowbrook/Rosa Parks Station
11720 Wilmington Ave
Los Angeles, CA 90059
Open: Monday through Friday, 6am to 6:30pm
(Closed Sat & Sun)

Telephone: (213) 922-6217 or persons with hearing or speech impairments can use California Relay Service 711 to contact Metro.

All completed online Employment Applications must be received by 5:00 p.m. on the closing date. Late applications will not be considered.

*Open to the public and all Metro employees

This job bulletin is not to be construed as an exhaustive list of duties, responsibilities, or requirements. Employees may be required to perform other related job duties.

*Please refer to the applicable benefit type (Regular or Temporary)*

BENEFITS FOR REGULAR EMPLOYEES

Benefits cover probationary or regular full-time (working at least 40 hrs/week) employees of Metro.

We offer a range of high-quality medical, dental and vision plan options as well as health care spending accounts for you and your family. Metro will cover a significant portion of your health care premiums.

Medical/Dental/Vision Plan- Employee has the choice of 3 separate medical plans and 3 dental plans. A separate vision plan is included in each medical plan.

Group Life Insurance- PTSC pays for an amount equal to your annual salary, rounded up to the nearest $1,000. Minimum amount of life insurance is $30,000.

Accidental Death & Dismemberment Insurance- PTSC provides $50,000 coverage for each employee. Additional voluntary coverage in amounts up to $500,000 is available at favorable premium rates.

Long-Term Disability Insurance- 100% employer paid. Provides employees with a minimum income of 60% of earnings after six months of disability. Buy up or buy down options available.

Holidays- 12 days a year: New Year's Day, Martin Luther King, Jr. Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Cesar E Chavez, Juneteenth,Thanksgiving Day, Day After Thanksgiving, and Christmas Day.

Time off with Pay (TOWP)- Compensates employees who are on approved absence from work for reasons such as illness, injury, medical and dental appointments, personal business, vacation, or observance of (a) religious holiday.
Years of Service Annual Accrual
Hire date - 5 years20 days
Beginning of 6th - 10th year25 days
Beginning of 11th - 15th year30 days
Beginning of 16th + years35 days

Pension Plan- PTSC retirement plan is the Public Employees' Retirement System (PERS). Vesting is five (5) years. Minimum retirement age is 52, based on the 2% at 62 formula.

Other Benefits: Transportation passes for employees and/or eligible dependents; Medicare; Tuition reimbursement; credit union membership; SDI; Deferred Compensation Plan; 401(K) Thrift plan; EAP; Medical and Dependent Care Flexible Spending Accounts; Flexible work schedules; and Jury Duty Pay.

BENEFITS FOR TEMPORARY EMPLOYEES

Temporary (Contingent) employees are eligible for the following benefits only:

• Kaiser medical insurance
• Public Pension Plan
• 457/401K Plan
• Flex Spending
• Paid Sick Time
• Fare Media
• Rideshare Subsidies
• Metro One Fitness membership

For more information on the Benefits Enrollment for Contingent Employees, please visit LA Metro’s Pension & Benefits website at www.benefits.metro.net .

Closing Date/Time: 8/8/2025 5:00 PM Pacific

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• Los Angeles County Metropolitan Transportation Authority - LA Metro

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