Hybrid WC Claims Adjuster – Experienced Analyst

ViziRecruiter,LLC.; Quincy (MA); Hybrid; USD 72,880 - 109,320; Full time

Job summary

Ahold Delhaize USA is seeking an Analyst II to manage a multi-jurisdictional Workers' Compensation caseload, ensuring timely, compliant, and cost-effective resolutions while supporting injured associates through recovery and return-to-work.

The role involves investigations, settlements, and coordination with internal partners across store, distribution, transportation, and HR to optimize claim outcomes and reduce lost time.

Qualifications

• Minimum 5 years of Workers' Compensation claims handling experience, including lost-time claims.
• 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.

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 elevate concerns in accordance with established protocols.
• Communicate clearly and professionally with associates, medical providers, attorneys, and vendors while maintaining strict confidentiality.

Skills

Negotiation

Analytical thinking

Problem solving

Communication

Prioritization

Adaptability

Education

Bachelor's degree or equivalent

Job description

Ahold Delhaize USA is seeking an Analyst II to manage a multi-jurisdictional Workers' Compensation caseload, ensuring timely, compliant, and cost-effective resolutions while supporting injured associates through recovery and return-to-work.

The role involves investigations, settlements, and coordination with internal partners across store, distribution, transportation, and HR to optimize claim outcomes and reduce lost time.