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Worker's Compensation Analyst II Claims Adjuster

Ahold Delhaize USA
Salisbury, USA
Full-time
Senior · 5+ years experience
Hybrid
USD 63440-109320 yearly / year
Discovered 1 months ago

Full Job Posting

  • 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 escalate concerns in accordance with established protocols.
  • Communicate clearly and professionally with associates, medical providers, attorneys, and vendors while maintaining strict confidentiality.
  • Manages an assigned book of WC claims aligned with departmental performance targets.
  • Works closely with the Safety team to enhance injury prevention and improve claim outcomes by sharing injury trends, supporting root-cause analysis, and reinforcing early intervention strategies focused on reducing lost time and claim escalation.
  • 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.
  • Experience handling Workers' Compensation claims in multiple jurisdictions.
  • Familiarity with retail, distribution, or transportation operations.
  • Working knowledge of FMLA, ADA, and return-to-work coordination.
  • Strong negotiation, analytical, and problem-solving skills.
  • Effective communication skills with internal and external partners.
  • Ability to manage competing priorities in a fast-paced, high-volume environment.
  • Demonstrated adaptability and willingness to grow technical claim expertise.

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