Workers Compensation Claims Adjuster Analyst I

Loyalty360; Scarborough (ME); On-site; USD 3,656,000 - 5,484,000; Full time

Job summary

Ahold Delhaize USA is seeking a Workers' Compensation Claims Manager to investigate and manage WC claims from start to settlement, interfacing with associates, attorneys, and providers. The role emphasizes adherence to deadlines, risk mitigation, and cross-functional collaboration.

The ideal candidate will hold a licensed adjuster status or ability to obtain one, plus a bachelor’s degree or equivalent WC claims experience, and strong negotiation and communication skills.

Qualifications

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

Responsibilities

• Investigation of workers' compensation claims to determine compensability.
• Manage WC caseload within targets and applicable authority.
• Ensure timely statutory filings and deadlines.
• Analyze facts to develop strategies and mitigate total cost of risk.
• Collaborate with safety, legal, and brand teams; communicate with stakeholders.
• Resolve claim issues via phone, email, and online applications.

Skills

Negotiation skills

Communication skills

Relationship building

Attention to detail

Problem solving

Education

Bachelor's degree or equivalent in related field

Job description

Category/Area of Expertise: Risk Management & Insurance
Job Requisition: 538804
Address: USA-ME-Scarborough-145 Pleasant Hill Rd
Store Code: Claims Management (5157501)

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

Position Summary:

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.

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

Principle Duties and 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.

Basic Qualifications:

• 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.

At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent.

Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies.

Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work.

We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.