Senior Claims Specialist, Insurance Risk Management (Workers' Comp)

About the role

A Senior Claims Specialist in Insurance Risk Management at VF is responsible for the administration and coordination of company-wide workers’ compensation, general liability, and automobile liability claims. This role partners closely with VF business stakeholders, brokers, and third-party claim administrators to ensure claims are managed efficiently, consistently, and in alignment with company objectives. The position drives effective claim outcomes, enhances the employee claims experience, and manages Total Cost of Risk (TCOR) through data-driven solutions.

Responsibilities

Claims Management

• Coordinate day-to-day management of workers’ compensation, general liability, and automobile liability claims, with emphasis on workers’ compensation in California.
• Partner with third-party administrators to monitor claim activity, influence claim strategy, ensure appropriate reserving, and drive timely and effective claim resolution.
• Manage and drive effective third-party administration of claims through proactive follow-up and case management.
• Track and manage claim lifecycle milestones, ensuring proactive follow-up and accountability across all stakeholders.
• Facilitate communication between VF business partners, adjusters, brokers, and other external parties to ensure alignment and transparency on claim status and strategy.
• Review claims for accuracy, completeness, and adherence to VF standards and applicable regulatory requirements.
• Support the development and execution of claim resolution strategies, including engagement with defense counsel, medical providers, and other vendors as needed.
• Monitor and identify trends, escalation points, and potential high-exposure claims, ensuring appropriate visibility and action.
• Apply technical knowledge of workers’ compensation, including California-specific laws and processes, to support claim decision-making and issue resolution.
• Review and challenge claim strategies, reserves, and action plans with third-party administrators to ensure alignment with VF objectives.
• Partner with VF Risk & Litigation Counsel and Paralegal, Litigation Operations on claim strategy and all phases of litigation for liability claims.
• Escalate high-risk issues to Director, Insurance Risk Management and Associate General Counsel, Employment, Litigation & Operations in a timely manner.
• Deliver a high-quality, service-oriented experience by supporting internal stakeholders and employees through the claims process.

General Department Responsibilities

• Support the preparation and delivery of claim reviews, reporting, and insights for leadership.
• Maintain, update, and identify areas of improvement within claim program materials, content, postings, and other compliance requirements across the VF Intranet, third-party administrator, and in VF facilities.
• Provide day-to-day support of internal and external risk management-related requests and business needs.
• Administer procedures for processing and payment of all department invoices and expenses.
• Other department support, compliance support, and special projects as needed.

Requirements

• 3-5 years of relevant claims experience, preferably in workers’ compensation, casualty claims, or a third-party administrator (TPA), carrier, or corporate risk management environment.
• Familiarity with California workers’ compensation laws, processes, and claim handling requirements preferred.
• Experience working with claims management systems (e.g., RMIS, TPA claim platforms).
• Proficiency in Microsoft Excel and data analysis to support reporting and claim review.
• Experience working in a multi-stakeholder environment, including coordination with TPAs, brokers, legal counsel, and internal business partners.
• Exposure to litigated claims and coordination with defense counsel preferred.
• Bachelor’s degree in Risk Management, Business, or related field preferred.
• Progress toward or interest in professional designations (e.g., AIC, WCCP, ARM, CPCU) is a plus.
• Experience supporting the management of claims, with a focus on workers’ compensation and general liability, including interaction with insurance companies, third-party administrators, and brokers.
• Working knowledge of the end-to-end claims management process, including reserving, litigation management, and cost containment strategies.
• Foundational knowledge of workers’ compensation, including familiarity with California-specific processes and requirements.
• Strong analytical, organizational, and time management skills, with the ability to prioritize competing demands and follow through on key deliverables.
• Sound judgment and problem-solving skills, with the ability to respond effectively in a fast-paced, evolving environment.
• Highly effective interpersonal and communication skills, with the ability to collaborate across internal teams and external partners.
• Demonstrated ability to work collaboratively and influence outcomes in a cross-functional, team-oriented environment.
• Customer-focused mindset, with a strong commitment to delivering a high-quality service experience and supporting VF business partners.
• Ability to identify operational issues, navigate ambiguity, and contribute to practical, solutions-oriented outcomes.
• Basic understanding of business and financial concepts as they relate to claim exposure and cost management.
• High attention to detail with strong follow-through and ownership of deliverables.

Pay

Hiring Range: $64,000.00 USD - $80,000.00 USD annually. This position is eligible for additional compensation awards that may include an annual incentive plan, sales incentive, or commission potential.

Benefits

Detailed information on benefits will be provided during the hiring process. You can review a general overview of each benefit program offered, including medical plan rates, on www.MyVFbenefits.com by clicking "Looking to Join VF?"