Workers' Compensation Specialist

The Judge Group; Reading (Berks County); On-site; USD 85,000 - 115,000; Full time

Job summary

The Judge Group is seeking a Senior Workers' Compensation Specialist to oversee multi-state claims administration, coordinate return-to-work programs, and partner with HR, safety, and external TPAs to ensure compliant and cost-effective claim management.

This individual contributor role focuses on complex claim activity, data analytics, reporting to leadership, and process improvements to reduce lost time while maintaining regulatory compliance.

Qualifications

• Bachelor's degree in a related field or equivalent experience.
• Minimum 5+ years of progressive workers' compensation experience.
• Experience managing multi-state workers' compensation claims.
• Strong communication with TPAs, carriers, medical providers, and legal counsel.
• Advanced Excel skills and data-driven reporting.

Responsibilities

• Oversee day-to-day administration of multi-state workers' compensation claims.
• Coordinate return-to-work and transitional duty programs.
• Monitor claim status, reserves, action plans, and settlements.
• Prepare reports and dashboards for leadership.
• Ensure compliance with state regulations and internal policies.
• Collaborate with HR, Safety, Operations, and TPAs.

Skills

Analytical skills

Communication

Multitasking

Excel proficiency

Education

Bachelor's degree in Risk Management, HR, Business Administration, Occupational Safety, Insurance

Tools

RMIS systems

HRIS platforms

Claim management systems

Job description

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 employees 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 claim costs and employee lost time.

This position is an individual contributor role with no direct reports.

Key Responsibilities

Claims Management & Oversight

• 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 escalate 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.

Return-to-Work & Accommodation Coordination

• 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.

Reporting, Analytics & Cost Management

• Analyze claim trends, loss data, and program metrics.
• Prepare recurring reports, dashboards, and presentations for leadership.
• 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.

Compliance & Program Administration

• Support compliance with applicable state workers' compensation regulations and reporting requirements.
• Maintain confidential employee 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 team members.
• Support special projects and other duties as assigned.

Qualifications & Experience

Required

• Bachelor's degree in Risk Management, Human Resources, Business Administration, Occupational Safety, Insurance, or a related field; equivalent experience may be considered.
• 5+ 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.

Preferred

• Experience in distribution, logistics, 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:
  • Associate in Claims (AIC)
  • Associate in Risk Management (ARM)
  • Certified Disability Management Specialist (CDMS)
  • Workers' Compensation Insurance Professional (WCIP)