Senior Workers Compensation Program Specialist
Socket.dev
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Benefits offered by this job
Job summary
S&S Activewear is seeking a Senior Workers' Compensation Specialist to lead multi-state claims administration, coordinate return-to-work, and monitor cost and compliance. This individual contributor role partners with TPAs, carriers, medical providers, and HR to drive timely resolution and optimal outcomes.
You will analyze trends, prepare reports, support audits, and help reduce claim costs while ensuring regulatory adherence and data accuracy across the organization.
Qualifications
- Bachelor's degree or equivalent in Risk Management, HR, Business Administration, Occupational Safety, Insurance, or related field.
- 5-7 years of progressive workers' compensation experience.
- Experience managing or coordinating multi-state workers' compensation claims programs.
- Strong analytical and problem-solving capabilities.
- Experience with TPAs, insurance carriers, medical providers, and legal counsel.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
Responsibilities
- Manage day-to-day administration of multi-state workers' compensation claims.
- Serve as the primary internal contact for workers' compensation claim activity.
- Coordinate return-to-work and transitional duty programs across the organization.
- Build and maintain relationships with TPAs, carriers, medical providers, and legal counsel.
- Analyze claim trends, loss data, and program metrics; prepare recurring reports and dashboards.
- Ensure compliance with state regulations and reporting requirements; support audits and documentation.
Skills
Education
Tools
Job description
S&S Activewear is a leading North American, tech-enabled specialty distributor of imprintable apparel, including t-shirts, fleece, athletic wear, headwear, workwear, scrubs and accessories. We pride ourselves on being the "critical link" that enables our 100+ brand partners such as Adidas, Columbia and Gildan to reach our hyper-fragmented base of customers, comprised of apparel decorators, eRetailers and promotional products distributors that embellish apparel items for diverse end consumer use cases (e.g., everyday wear, concerts, fitness attire, life events, team sports, etc.). At S&S, we differentiate in the market through a customer service focus, strategic product portfolio, world-class distribution infrastructure, a collaborative growth culture and a relentless focus on technology and innovation.
Our success has compounded since the Company’s humble beginnings in 1988 as a regional t-shirt distributor to a leading, multi-billion-dollar value-added distribution platform that drives market penetration for our suppliers while enabling the growth, operations and fulfillment for a diverse range of customers across channels and business sizes. We strive to be the apparel distributor of choice while inspiring and fostering growth for customers, employees and suppliers through our core values of service, deep relationships, innovation, continuous improvement and accountability.
The Senior Workers' Compensation Specialist serves as a key member of the Company's workers' compensation program and is responsible for the day-to-day administration, oversight, and coordination of multi-state workers' compensation claims and return-to-work activities.
Working under the direction of the Workers' Compensation Manager, this position partners closely with Human Resources, Safety, Operations, third-party administrators (TPAs), medical providers, legal counsel, and team members to ensure timely claim resolution, effective return-to-work outcomes, regulatory compliance, and cost-effective claim management.
The Senior Workers' Compensation Specialist functions as the primary operational lead for workers' compensation claims administration and program execution. This role independently manages complex claim activity, facilitates communication among stakeholders, identifies trends and opportunities for improvement, and supports organizational efforts to reduce overall trends or areas of concern.
This position is an individual contributor role with no direct reports.
Salaried: based on experience
Onsite Monday - Friday (standard business hours), Full-Time, Exempt
We offer a comprehensive benefits package designed to support your life, health, and future. Benefits begin 0-90 days after hire and include Vacation, Personal, and Sick time; Medical, Dental, Vision, Life Insurance, and Disability coverage; Flexible Spending Accounts; and a 401(k) plan. You’ll also enjoy discounts on brand-name apparel, fun employee events, and meaningful opportunities for growth and advancement. Join a company that invests in you from day one.
- Manage and oversee the day-to-day administration of multi-state workers' compensation claims.
- Serve as the primary internal contact for workers' compensation claim activity.
- Partner with TPAs, carriers, nurse case managers, and medical providers to monitor claim progress and ensure appropriate handling.
- Review claim status, reserves, action plans, and settlement recommendations and elevate concerns to the Workers' Compensation Manager as appropriate.
- Coordinate investigations of workplace injuries and ensure timely and accurate claim reporting.
- Monitor claim compliance with company standards, state regulations, and service expectations.
- Assist with resolution of complex, litigated, and high-exposure claims.
- Coordinate return-to-work and transitional duty programs across the organization.
- Collaborate with Human Resources, managers, Safety, and healthcare providers to facilitate early and safe return-to-work opportunities.
- Track employee work status restrictions and accommodations.
- Monitor duration and effectiveness of modified-duty assignments.
- Identify barriers to successful return-to-work outcomes and recommend solutions.
- Support compliance with applicable leave and accommodation programs as needed.
- Build and maintain productive working relationships with TPAs, carriers, medical providers, legal counsel, and other program partners.
- Facilitate communication among employees, managers, Human Resources, Safety, and Operations regarding claim activity.
- Respond to escalated workers' compensation questions and issues.
- Participate in claim review meetings and vendor performance discussions.
- Ensure vendors are providing timely and quality service in support of program objectives.
- Analyze claim trends, loss data, and program metrics.
- Prepare recurring reports, dashboards, and presentations for internal stakeholders.
- Monitor claim costs, reserve development, and closure rates.
- Identify opportunities to reduce workers' compensation costs and improve program performance.
- Support annual budgeting, forecasting, actuarial reviews, and insurance renewal activities.
- Maintain accurate program records and reporting systems.
- Support compliance with applicable state workers' compensation regulations and reporting requirements.
- Maintain confidential team member medical and claim-related records.
- Assist with audits, regulatory requests, and documentation reviews.
- Ensure claim and injury documentation is complete and maintained according to company standards.
- Monitor program compliance and identify operational risks requiring management attention.
- Recommend and implement process improvements that enhance service, efficiency, and claim outcomes.
- Participate in workers' compensation and safety initiatives designed to reduce workplace injuries and claim frequency.
- Assist with development of training materials and educational resources for managers and employees.
- Support special projects and other duties as assigned.
- Bachelor's degree in Risk Management, Human Resources, Business Administration, Occupational Safety, Insurance, or a related field; equivalent experience may be considered.
- 5-7 years of progressive workers' compensation experience.
- Experience managing or coordinating multi-state workers' compensation claims programs.
- Working knowledge of workers' compensation claim handling practices, return-to-work programs, and claim cost containment strategies.
- Experience working with TPAs, insurance carriers, medical providers, and legal counsel.
- Strong analytical and problem-solving capabilities.
- Advanced Microsoft Excel proficiency and experience preparing reports and dashboards.
- Excellent verbal, written, and interpersonal communication skills.
- Ability to handle sensitive and confidential information.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
- Experience in distribution, logistics, transportation, manufacturing, retail, or warehouse operations.
- Experience supporting large, multi-location workforces.
- Knowledge of OSHA recordkeeping requirements.
- Experience with Risk Management Information Systems (RMIS), claim management systems, and HRIS platforms.
- Professional certifications such as:
- Workers' Compensation Professional (WCP®)
- Associate in Claims (AIC)
- Associate in Risk Management (ARM)
- Certified Disability Management Specialist (CDMS)
- Workers' Compensation Insurance Professional (WCIP)
- Workers' Compensation Claims Management
- Return-to-Work Program Administration
- Vendor & TPA Management
- Claim Cost Containment
- Multi-State Workers' Compensation Programs
- Regulatory Compliance
- Data Analytics & Reporting
- Risk Assessment
- Employee Relations
- Process Improvement
- Communication & Influencing Skills
- Stakeholder Management
- Problem Solving & Decision Making
- Confidential Information Management
- Cross-Functional Collaboration
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job.
This position operates in a professional office environment and may be structured as on-site, remote, or hybrid depending on business needs. This role requires the use of standard office equipment and collaboration with internal teams.
S&S Activewear welcomes people of all backgrounds and experiences and are committed to creating a diverse culture and supporting human growth. We are proud to be an equal opportunity employer and are committed to providing equal opportunity for all employees and applicants. We conduct business without regard to sex, race, creed, color, religion, marital status, national origin, citizenship status, age, pregnancy, sexual orientation, gender identity or expression, genetic information, disability, military status, status as a veteran, or any other protected characteristic. Our policy is to recruit, hire, train, promote, assign, transfer, and terminate employees based on their own ability, achievement, experience and conduct and other legitimate business reasons. S&S participates in E-Verify and will provide the federal government with your Form I-9 information to confirm you are authorized to work in the U.S.
This job offer is contingent upon the completion of a satisfactory background check.
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