Analyst II Claims Adjuster

Adusa; Scarborough (ME); Híbrido; USD 63.000 - 109.000; Jornada completa

Descripción de la vacante

Ahold Delhaize USA is seeking an experienced Analyst II to manage a workload of Workers' Compensation claims across multiple jurisdictions. This independent claims handler supports injured associates through recovery and return-to-work while ensuring timely, compliant, and cost-effective resolutions.

Hybrid schedule: 1 day in-person at a core location (Salisbury, NC; Scarborough, ME; Quincy, MA; Carlisle, PA) and 4 remote days.

Formación

• Minimum 5 years of Workers' Compensation claims adjudicating experience, including lost-time claims.
• Hands-on experience gathering statements, evidence, reviewing medical records, determining compensability, establishing reserves, and managing claims to resolution.
• Active adjuster license(s) as required by jurisdiction, or ability to obtain.
• Bachelor's degree or equivalent professional experience.
• Working knowledge of Workers' Compensation statutes, claim handling practices, and medical terminology.

Responsabilidades

• Manage an assigned caseload of Workers' Compensation claims in compliance with state laws and company policies.
• Investigate to determine compensability, evaluate exposure, and develop claim strategies.
• Negotiate and manage settlements within authority levels.
• Actively manage medical treatment to minimize disability duration and promote return-to-work.
• Collaborate with Store Management, Distribution, Transportation and HR to support RTW initiatives.
• Coordinate with PBM partners to monitor prescriptions and ensure injury-related medications.
• Identify potential fraud indicators and escalate as needed.
• Communicate clearly with associates, medical providers, attorneys and vendors while maintaining confidentiality.

Conocimientos

Negotiation

Analytical

Problem-solving

Communication

Prioritization

Adaptability

Educación

Bachelor's degree

Descripción del empleo

Introduction

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which also includes five leading omnichannel grocery brands – Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Ahold Delhaize USA associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.

Overview

The Analyst II role is an experienced adjusting position responsible for managing a caseload of incident-only, medical-only, and lost-time Workers' Compensation claims across multiple jurisdictions. This role functions as an independent claims handler, ensuring timely, compliant, and cost-effective claim resolution while supporting injured associates through recovery and return-to-work.
Analysts collaborate closely with internal partners and vendors and elevate complex issues to Specialists, Analyst III resources, or the Team Manager as appropriate. The role does not have direct people-management responsibility.
This position follows a hybrid schedule (1 day in-person at a core location, 4 remote days). This position can be based in one of our offices located in Salisbury, NC, Scarborough, ME, Quincy, MA and Carlisle, PA.
Applicants must be currently authorized to work in the United States on a full-time basis.

Responsibilities

• Manage an assigned caseload of incident-only, medical-only, and lost-time Workers' Compensation claims in compliance with applicable state laws and company policies.
• Conduct timely investigations to determine compensability, evaluate exposure, and develop appropriate claim strategies.
• Negotiate and manage settlements within assigned authority. Authority levels vary based on experience and demonstrated competency and align with corporate guidelines.
• Actively manage medical treatment to minimize disability duration and promote safe, timely return-to-work.
• Partner closely with Store Management, Distribution, Transportation, and Human Resources to support participation in the Light Duty RTW Program.
• Utilize nurse triage services at injury intake and during early claim activity to ensure appropriate care direction and reduce unnecessary emergency room utilization.
• Coordinate with PBM partners to monitor prescriptions and ensure medications are injury-related and appropriate.
• Identify potential fraud indicators and escalation concerns in accordance with established protocols.
• Communicate clearly and professionally with associates, medical providers, attorneys, and vendors while maintaining strict confidentiality.

Financial & Operational Impact

• Manages an assigned book of WC claims aligned with departmental performance targets.
• Works closely with the Safety team to enhance injury prevention and improve claim outcomes by sharing injury trends, supporting root-cause analysis, and reinforcing early intervention strategies focused on reducing lost time and claim escalation.

Requirements

• Minimum 5 years of Workers' Compensation claims adjudicating experience, including lost-time claims.
• Requires extensive, hands‑on experience investigating and adjudicating claims, including gathering statements and evidence, reviewing medical records, determining compensability, establishing reserves, and managing claims through resolution.
• Active adjuster license(s), as required by jurisdiction, or ability to obtain.
• Bachelor's degree or equivalent professional experience.
• Working knowledge of Workers' Compensation statutes, claim handling practices, and medical terminology.

Preferred Qualifications

• Experience handling Workers' Compensation claims in multiple jurisdictions.
• Familiarity with retail, distribution, or transportation operations.
• Working knowledge of FMLA, ADA, and return-to-work coordination.

Skills & Abilities

• Strong negotiation, analytical, and problem‑solving skills.
• Effective communication skills with internal and external partners.
• Ability to manage competing priorities in a fast‑paced, high‑volume environment.
• Demonstrated adaptability and willingness to grow technical claim expertise.

ME/NC/PA/SC Salary Range: $63,440-$95,160
IL/MA/MD/NY Salary Range: $72,880 - $109,320

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.