Senior Workers' Comp Claims Analyst II

Adusa; Carlisle (Cumberland County); Hybride; USD 63 440 - 109 320; Plein temps

Résumé du poste

Ahold Delhaize USA seeks an Analyst II to manage a caseload of incident-only, medical-only, and lost-time workers' compensation claims across multiple jurisdictions. This role acts as an independent claims handler, ensuring timely, compliant, and cost-effective claim resolution while supporting injured associates through recovery and return-to-work.

This position follows a hybrid schedule (1 day in-person at a core location, 4 remote days) and requires active adjuster license(s) or ability to

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.

Responsabilités

• 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.

Connaissances

Negotiation

Analytical

Problem-solving

Communication

Time management

Formation

Bachelor's degree or equivalent

Description du poste

Ahold Delhaize USA seeks an Analyst II to manage a caseload of incident-only, medical-only, and lost-time workers' compensation claims across multiple jurisdictions. This role acts as an independent claims handler, ensuring timely, compliant, and cost-effective claim resolution while supporting injured associates through recovery and return-to-work.

This position follows a hybrid schedule (1 day in-person at a core location, 4 remote days) and requires active adjuster license(s) or ability to