Workers Compensation Claims Adjuster Analyst I

ViziRecruiter,LLC.; Salisbury, Northern (NC, KY); On-site; USD 37,000 - 63,000; Full time

Job summary

Ahold Delhaize USA is seeking a claims professional to investigate workers' compensation claims, manage the file through resolution, and collaborate with safety and brand partners. This role interfaces with associates, attorneys, healthcare providers, and vendors to resolve issues, while meeting service levels.

The position supports a flexible hybrid work model with one in-person day and remote days, and requires authorization to work in the United States on a full-time basis.

Qualifications

• Licensed adjuster or ability to obtain license by jurisdiction.
• Bachelor's degree or 4 years WC claims experience.
• Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation claims.
• Knowledge of medical terminology involved in complex claims.
• Strong negotiation skills.

Responsibilities

• Manage WC caseload within established targets and appropriate level.
• Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
• Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome.
• Identify fraud indicators and actively pursue subrogation opportunities.
• Collaborate with the Safety department to identify hazards and minimize risks.
• Build and maintain relationships with internal and external customers.

Skills

Relationship building

Written and verbal communication

Self-motivated

Customer focus

Critical thinking

Multitasking

Problem solving

Negotiation

Education

Bachelor's degree

Job description

Introduction

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which also includes five leading omnichannel grocery brands – Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Ahold Delhaize USA associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.

Overview

Primary responsibilities include investigation of Workers Compensation claims to determine either compensability of the claim. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals.

This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners.

Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. This position can be based in one of our offices located in Salisbury, NC, and Quincy, MA.

Applicants must be currently authorized to work in the United States on a full-time basis.

Responsibilities

Claims Management

• Manage WC caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations.
• Monitor and ensure timely execution of all statutory deadlines or legal filings as needed.
• Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
• Identify fraud indicators and actively pursue subrogation opportunities.
• Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks.
• Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers.

Financial Impact Administration

• Manage book of claims business (up $1 million WC) with authority to settle/negotiate a single claim within their authority of up to $50,000 (Corporate Authority policy)
• Communicate ongoing causes of WC injuries to Safety and Brands.
• Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications.

Requirements

• Licensed adjuster or ability to obtain license (as appropriate by jurisdiction)
• Bachelor's degree or 4 years WC claims experience
• Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation claims.
• Knowledge of medical terminology involved in complex claims
• Strong negotiation skills.

Skills and Abilities:

• Demonstrates -relationship building and communication skills, both written and verbal.
• Highly self-motivated, goal oriented, and works well under pressure.
• Customer focused solid understanding of WC legal procedures, processes, practices and standards in the handling of complex claims
• Ability to identify problems and effectuate solutions
• Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail
• Able to apply critical thinking when solving problems and making decisions.

ME/NC/PA/SC Salary Range:$26.54 - $39.81

IL/MA/MD/NY Salary Range:$30.54 - $45.81

Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.