Claims Professional

Wawa, Inc; United States; On-site; USD 75,000 - 110,000; Full time

Benefits offered by this job

Employee Stock Ownership Plan (ESOP)

401(k) Plan

Medical/Dental/Prescription Coverage

Flexible Spending Accounts (Health & F

Employee Assistance & Wellness

Job summary

Wawa, Inc. is seeking a Claims Professional to manage a book of business and act as the main point of contact for TPA adjusters.

You will ensure claims are handled efficiently, in line with Wawa’s SOPs and the SSI guidelines, while overseeing communications across the company. The role involves coordinating with external counsel, reviewing investigations to determine risk exposure, and escalating complex claims to senior management.

Qualifications

• Bachelor’s Degree in related field preferred (Risk Management, Finance, Criminal Justice)
• 2-4 years working in worker’s compensation or liability insurance claims environment required
• Ability to use multiple systems to review adjuster notes and run loss reports
• Expert usage of Microsoft Office (M365)

Responsibilities

• Act as the Main Point of Contact (MPOC) for TPA Adjusters.
• Oversee the quality of service provided by the TPA vendor to ensure SOPs and Wawa standards are followed.
• Review materials from claims investigations to determine risk exposure and appropriate action.
• Set/approve settlements and reserves within authority; escalate as needed.
• Meet with TPA adjusters regularly to review claims in your book of business.

Skills

Communication skills

Customer service

Analytical skills

Problem solving

Detail oriented

Education

Bachelor’s Degree

Tools

Microsoft Office (M365)

Job description

Job Description Job Title: Claims Professional Location: Corporate Department: Risk Management Job Summary: The Claims Professional will handle claims in their book of business to ensure claims are closed in the most efficient manner and time while being handled within Wawa’s established SOPs. Claims Analyst III will be the main point of contact for TPA adjusters under their book of business and oversee all communications within Wawa to ensure proper claim handling and follow-up. In this position approximately 80% of claims assigned should be autonomously managed.

Principal Duties: Act as the Main Point of Contact (MPOC) for TPA Adjusters. Oversee the quality of service provided by the TPA vendor for your claims to ensure SPOs are being followed, the “Wawa Way” is being implemented, and claims are handled following the Special Service Instructions (SSI) by the TPA. Review materials gathered during the claims investigation to determine Wawa’s level of Risk Exposure and proper course of action to close claim in a timely manner. Early detection and elevation of potentially complex claims when needed to Senior Management. Set/Approve settlement and/or reserves within your authority for each claim and elevate to more senior Claims Analyst or Risk Management leadership as needed to secure proper reserves. Participate in the committee to evaluate and manage external Legal Counsel Panel. Assign Defense Counsel from the established legal counsel panel as per SOPs when needed. Meet with TPA adjusters regularly to review claims within your book of business. Document and take/request corrective action with TPA Claims managers, TPA Account Manager, when needed to correct inappropriate or lack of action of any TPA Adjuster. Oversee the completion of interrogatories in conjunction with External Counsel. Act as Signatory for the submitted interrogatories on behalf of Wawa. Act as the MPOC for store management or associate’s questions Serve as primary contact with Call Center to provide input to ensure quality claim reporting and customer service. Strategize for and attend arbitration, mediation, settlement conferences, or trials as needed. Review and approve request from TPA to assign investigative and expert services within SOP guidance. Identify trends that are causing claims to occur and elevate them to Risk Management Leadership. Participate in Safety Committee meetings. Undertake and lead projects when required. Perform other tasks and duties as assigned.

Essential Functions

• Ability to work well individually as well as in a team environment
• Excellent oral and written communication skills
• Excellent customer service skills
• Ability to work with little or no supervision
• Detail oriented and strong organizational skills
• Strong analytical and problem-solving skills
• Ability to handle multiple projects
• Excellent interpersonal skills
• Proven self-starter with demonstrated ability to make decisions
• Ability to accept tasks and direction and to bring tasks to a timely conclusion
• Desire to gain valuable claim experience in multi-lines of coverage Ability to handle incident and injury descriptions, photos, and videos that may be graphic in nature
• Ability to keep confidentiality

Basic Qualifications

• Bachelor’s Degree in a related field preferred (Risk Management, Finance, Criminal Justice)
• 2-4 years working in worker’s compensation or liability insurance claims environment required
• Ability to use multiple systems to review adjuster notes and run loss reports
• Expert usage of Microsoft Office (M365

Wawa will provide reasonable accommodation to complete an application upon request, consistent with applicable law. If you require an accommodation, please contact our Associate Service Center at [e-mail]. Wawa, Inc. is an equal opportunity employer. Wawa maintains a work environment in which Associates are treated fairly and with respect and in which discrimination of any kind will not be tolerated. In accordance with federal, state and local laws, we recruit, hire, promote and evaluate all applicants and Associates without regard to race, color, religion, sex, age, national origin, ancestry, familial status, marital status, sexual orientation or preference, gender identity or expression, citizenship status, disability, veteran or military status, genetic information, domestic or sexual violence victim status or any other characteristic protected by applicable law. Unlawful discrimination will not be a factor in any employment decision.

Here at Wawa, the sky's the limit. Voted as “America’s Favorite Convenience Store,” Wawa operates a chain of convenience retail stores located in Pennsylvania, New Jersey, Delaware, Maryland, Virginia, Florida, Alabama, North Carolina and Washington D.C. Today, Wawa is your all day, every day stop for fresh, built-to-order foods, beverages, coffee, fuel services, and surcharge-free ATMs. We're making every day a little more fulfilling—one smile, hoagie, and experience at a time. We know that it's our Associates who put the “wow” in working at Wawa, so we're invested in giving them the encouragement they need to take flight. By providing flexibility and support, at work and beyond, we create an environment where everyone can thrive. We believe that with the right ingredients to grow and build a career—and a little wind beneath the wings—our Associates can reach new heights. Guided by our commitment to community, Wawa Associates take pride in putting people first, making days brighter, and bringing joy to our friends and neighbors. With opportunities such as volunteering, charitable giving, and events, we're able to extend care beyond the workplace, building stronger neighborhoods and long-lasting relationships.

We have benefits that fuel well-being, including:

• * Employee Stock Ownership Plan (ESOP) Tuition Reimbursement 401(k) Plan Medical/Dental/Prescription Coverage Flexible Spending Accounts (Health Care & Dependent Care) Employee Assistance & Wellness Programs Employee Credit Union Paid Time Off Employee Resource Groups
• *eligibility requirements may apply

For Technical Issues regarding your application please email: [e-mail].