Senior Specialist, Claims

About the Role

This is a hybrid individual-contributor role based in either Pineville, North Carolina; Oakville, Ontario; or Montreal, Quebec, reporting to the Director, Health, Safety & Environment. The Senior Specialist, Claims manages occupational injury, illness, disability, and related claims end-to-end, ensuring compliance with Canadian and U.S. regulatory requirements. The role serves as a key liaison between employees, leaders, healthcare providers, insurers, and regulatory authorities, balancing employee well-being with operational and financial objectives.

Responsibilities

• Manage claims from first notice of loss through resolution, including occupational injury, disability, bodily injury, and property damage claims.
• Assess claim eligibility and submit required reports to workers' compensation boards, insurers, and regulatory bodies.
• Maintain accurate claim records, documentation, and data integrity.
• Review and reconcile claim cost statements; investigate and resolve discrepancies.
• Partner with operational leaders to support modified work, accommodations, and return-to-work (RTW) plans.
• Liaise with workers' compensation authorities, insurers, healthcare providers, and other external stakeholders.
• Coordinate and participate in accommodation and RTW meetings to facilitate safe, timely employee reintegration.
• Monitor legislative and regulatory changes across Canada and the U.S., providing guidance on reporting, accommodation, and claims management requirements.
• Collaborate with internal legal teams and external counsel on complex claims, litigation, cost recovery, and settlements.
• Serve as a primary contact for internal and external stakeholders, ensuring timely and effective communication.
• Prepare regulatory submissions, objections, cost relief applications, internal reports, and executive summaries.
• Represent the employer in appeals and administrative proceedings, as required.
• Analyze claims data and trends to identify risk reduction and prevention opportunities.
• Contribute to the continuous improvement of HSE, incident management, and claims processes.

Requirements

• Post-secondary education in Human Resources, Occupational Health, Nursing, Kinesiology, Business Administration, or a related field.
• Disability management or claims-related certification (e.g., CDMP) is an asset.
• Bilingual in English and French.
• 3+ years of experience in occupational claims, disability/absence management, workers' compensation, or a related claims function within U.S. and/or Canadian jurisdictions.
• Experience managing end-to-end claims processes, including eligibility assessment, regulatory reporting, case management, and cost monitoring.
• Experience with objections, appeals, cost relief applications, or administrative/legal review processes is an asset.
• Strong knowledge of workers' compensation legislation, human rights and accommodation requirements, privacy legislation, and occupational health and safety standards.
• Excellent communication, collaboration, organization, problem-solving, and decision-making skills.
• Strong attention to detail and ability to manage confidential information and records with accuracy.

IPEX is committed to providing accommodations for people with disabilities throughout the recruitment process. To request an accommodation, please contact HR at HR@ipexna.com.