Claims & Compliance Specialist

About the role

The Claims & Compliance Specialist is responsible for coordinating employee claims and occupational compliance programs, including workers' compensation, DOT regulations, drug and alcohol testing, occupational health requirements, and other regulatory programs that support employee safety and organizational compliance. This position serves as the organization's Designated Employer Representative (DER) for its DOT Drug & Alcohol testing program and is authorized to take actions under 49 CFR Part 40. The Claims & Compliance Specialist acts as the primary liaison between employees, managers, medical providers, insurance carriers, occupational health vendors, and regulatory agencies. The Claims & Compliance Specialist ensures compliance with applicable federal, state, and company requirements while providing exceptional customer service to employees and leadership. The position works closely with Human Resources, Payroll, Safety, and Operations to ensure timely claims management, regulatory compliance, and continuous improvement of related processes.

Responsibilities

Claims Administration – 50%

• Administer workers' compensation, disability, property/casualty, and other employment-related insurance claims.
• Coordinate claim reporting, documentation, and communication with insurance carriers, third-party administrators, employees, managers, and medical providers.
• Monitor open claims and proactively follow up to ensure timely resolution.
• Coordinate return-to-work activities and transitional duty assignments in partnership with managers.
• Maintain accurate claim files and documentation while protecting confidential medical information.
• Identify trends and recommend process improvements to reduce claim frequency and costs.

Compliance & Occupational Health – 40%

• Serve as the company's Designated Employer Representative (DER) for the DOT Drug & Alcohol Testing Program in accordance with 49 CFR Part 40.
• Maintain sufficient knowledge of DOT drug and alcohol testing requirements and Company policies to effectively administer the program and appropriately respond to testing situations.
• Coordinate random, post-accident, reasonable suspicion, return-to-duty, and follow-up drug and alcohol testing.
• Schedule and coordinate DOT and non-DOT physicals, fit-for-duty examinations, respirator clearances, and other occupational health services.
• Maintain DOT Driver Qualification Files and ensure ongoing regulatory compliance.
• Monitor compliance deadlines and proactively coordinate renewals and required documentation.
• Maintain confidential medical records in accordance with applicable federal, state, and company requirements.
• Serve as the primary point of contact for occupational health vendors, testing facilities, and regulatory agencies.
• Assist with OSHA, MSHA, and other regulatory reporting and documentation, as assigned.

HR Operations & Process Coordination – 10%

• Prepare reports and maintain records supporting Human Resources, Safety, and regulatory compliance initiatives.
• Develop, maintain, and improve standard operating procedures for claims and compliance programs.
• Provide administrative support for HR compliance initiatives, audits, and regulatory reviews.
• Recommend process improvements that increase efficiency, consistency, regulatory compliance, and employee service.

Requirements

• Degree in Environmental, Health & Safety, or the equivalent of two years' experience in a similar role.

Qualifications

• Persistence and comfort asking hard questions; willingness to push for answers, challenge inconsistencies, and follow up repeatedly with medical providers, managers, insurance carriers, employees, and others to keep claims moving toward resolution.
• Highly organized with a big-picture mindset; ability to manage multiple claims, deadlines, appointments, restrictions, and follow-ups at once without losing sight of the overall goal.
• Takes ownership; proactively notices stalled claims, identifies obstacles, and takes steps to get them back on track.
• Strong integrity, coachability, effective communication, and enjoyment of collaborating as part of a cross-functional team.