Senior Workers' Comp Claims Analyst (Hybrid)

ViziRecruiter,LLC.; Salisbury (NC); Hybrid; USD 63,440 - 95,160; Full time

Job summary

Ahold Delhaize USA is seeking an Analyst II to manage 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 resolution while supporting injured associates through recovery and return-to-work.

The position emphasizes collaboration with internal partners and vendors, escalation to specialists when needed, and adherence to corporate

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.

Responsibilities

• Manage an assigned caseload of incident-only, medical-only, and lost-time Workers' Compensation claims in compliance with state laws and company policies.
• Conduct timely investigations to determine compensability, evaluate exposure, and develop appropriate claim strategies.
• Negotiate and manage settlements within authority levels, aligned 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

Problem-solving

Communication skills

Education

Bachelor's degree or equivalent

Job description

Ahold Delhaize USA is seeking an Analyst II to manage 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 resolution while supporting injured associates through recovery and return-to-work.

The position emphasizes collaboration with internal partners and vendors, escalation to specialists when needed, and adherence to corporate