Claims processor Jobs in Downey, CA

WC Analyst

The WC Analyst position entails receiving first notice of injuries from the Stores via Nurse Triage Reporting, email, or phone call. They are responsible for maintaining an accurate log of all injury reports received and setting up the initial claim of injury and reporting to the insurance company/TPA. This position is in constant communication with the injured worker, the store, the insurance company, medical providers, and any attorney involved in the file. The analyst maintains updated medical status on all open files and assigns investigators if necessary. They must summarize and present requests for settlement authority to upper management. This person attends and participates in Quarterly claims review with the insurance carrier/TPA. Further responsibilities include coordinating modified duties as needed for the injured worker either on or offsite, reviewing and approving medical bills received from the clinics as it pertains to pre-employment and post injury care charges, and generate reports on a monthly and quarterly basis and provide them to Director of Risk. They will work closely with Human Resources to obtain pertinent information and inform them of current status on any open claim when needed.

Roles & Responsibilities:

1. Daily data entry into the Workers Compensation log and into the database (WCCMS) is required.
2. Setting up the initial file for injury and determining if this is a claim that needs to be reported to the insurance company, it is a Medical Only, Indemnity claim or if it is a possible non-industrial incident.
3. Investigate new losses and report losses to TPA/Carrier with supportive documentation
4. Responsible for assisting two Districts and managing all losses and working with the TPA.
5. Liaison between Operations and TPA for workers compensation claims process
6. Participates in claims review with the insurance carrier/TPA
7. Documentation of file activities in accordance with established policy and maintenance of an effective diary management system to ensure timely handling of claims
8. Coordinate return to work program with injured workers, Stores and TPA
9. Maintain updated medical status on all open files
10. Daily communication with injured workers, stores, and insurance company required.
11. Generate weekly reports regarding modified duty status.
12. Provide support to adjuster and defense counsel in securing all documents for discovery
13. Log new claims into Open Claims for the pertaining month.
14. Generate weekly, monthly, quarterly reports as needed by senior management.
15. Follow-up with store management, vendors and injured workers on a daily basis.
16. Regularly review files for closure and request claim status updates.
17. Review and document claim work status reports.
18. Provide the Human Resources department with updated information as it affects their respective departments
19. Provide monthly charge back report to CFO.
20. Review and analyze video surveillance for all injuries.
21. Participate in WC presentations when necessary.
22. Assist the Risk Department with all the responsibilities required to maintain optimal department efficiency.

Video System Surveillance

• Review all video on claims reported by the Stores
• Attached video result into the claim folder for use
• Advise Loss prevention on any problems with store video system.

Job Requirements:

Education:

• High School Diploma or Equivalent
• College Degree Preferred
• Professional Certification (WCCA/WCCP) desirable

Experience:

• 2-5 years experience in handling Workers Compensation claims.
• 1-3 years experience dealing with Self Insured employer.

Knowledge:

• Proficiency in Microsoft applications (e.g.-Excel, Outlook, Word, Power Point).
• Experience with managing a claims Database system.
• Typing 35 WPM
• Experience with 10 key, fax and multi-line phone system.
• Bi-Lingual preferred English/Spanish

Skills and Ability:

• Excellent communication skills required.
• Good interpersonal skills.
• Be able to deal with delicate situations and maintain confidentiality.
• Ability to interact and work in conjunction with other departments within the company.
• Ability to work independently.
• Analytical and Problem-Solving skills.

Range: $28.00 to $33.00

About Superior Grocers Founded in 1981, Superior Grocers is one of the largest independent supermarket chains in the Western U.S., operating 74 stores across California and Nevada with approximately 7,000 employees. Recognized as the 2026 "Top Hispanic Supermarket in the U.S." by Abasto, we are committed to serving our customers, supporting our communities, and creating growth opportunities for our team members.

Our culture is grounded in four core values - Integrity, Service, Passion, and Excellence - which guide how we serve customers and develop our people. We strive to create a respectful, supportive workplace where employees can thrive and make a meaningful impact.

Why Join Us We offer competitive pay, comprehensive benefits (medical, dental, vision, 401k, PTO), tuition assistance, employee support programs, and career development opportunities. At Superior Grocers, you'll find a collaborative environment with strong potential for growth and a chance to positively impact the communities we serve.

Superior Grocers is an Equal Opportunity Employer

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.