Senior WC Claims Analyst — Hybrid, Multi-Jurisdiction

Adusa; Scarborough (ME); Hybrid; USD 63,000 - 109,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Negotiation

Analytical

Problem-solving

Communication

Prioritization

Adaptability

Education

Bachelor's degree

Job description

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.