Workers Compensation Claims Adjuster Analyst I

About the role

Primary responsibilities include investigation of Workers Compensation claims to determine compensability. This role manages the claim in its entirety while maintaining service level targets and achieving established claims goals. This position serves as the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.

Responsibilities

• Claims Management: Manage WC caseload within established targets and appropriate level, including thorough investigations, evaluations, negotiation and disposition of all claims in compliance with statutory and legal obligations.
• Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
• Analyze facts of loss to develop strategies that provide optimal outcomes and mitigate the overall Total Cost of Risk.
• Identify fraud indicators and actively pursue subrogation opportunities.
• Collaborate with the Safety department to identify hazards in retail and distribution operations and ways to minimize risks.
• Build and maintain positive relationships with internal (Brands, Distribution Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) stakeholders.
• Serve as the primary point of contact to address and resolve claim issues impacting customers, associates, vendors, and Brands.
• Research and resolve claim/legal issues and provide timely communication related to claims.
• Financial Impact Administration: Manage a book of claims business (up to $1 million WC) with authority to settle/negotiate a single claim within an authority of up to $50,000 per Corporate Authority policy.
• Communicate ongoing causes of WC injuries to Safety and Brands.

Requirements

• Licensed adjuster or ability to obtain license (as appropriate by jurisdiction)
• Bachelor's degree or 4 years WC claims experience
• Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation claims
• Knowledge of medical terminology involved in complex claims
• Strong negotiation skills

Skills

• Demonstrates relationship building and communication skills, both written and verbal
• Highly self-motivated, goal oriented, and works well under pressure
• Customer focused with a solid understanding of WC legal procedures, processes, practices and standards in handling complex claims
• Ability to identify problems and effectuate solutions
• Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail
• Able to apply critical thinking when solving problems and making decisions

This position can be based in one of our offices located in Salisbury, NC, and Quincy, MA. Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full-time basis.

Pay

• ME/NC/PA/SC Salary Range: $26.54 - $39.81 per hour
• IL/MA/MD/NY Salary Range: $30.54 - $45.81 per hour
• Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.