Workers' Compensation Claims Associate

POSITION SUMMARY

The Workers’ Compensation Associate Leads the strategic oversight of a portfolio of workers’ compensation indemnity claims handled by our carrier and Third-Party Administrator (TPA) partners. This role is designed for experienced adjusters seeking to expand beyond traditional claim handling into a more consultative, client-facing position with broader influence on claim outcomes and total cost of risk.

Apply deep technical claims expertise to evaluate reserves, settlement strategies, and claim direction, while partnering with clients, adjusters, and internal stakeholders to drive optimal outcomes.

ESSENTIAL DUTIES & JOB REQUIREMENTS

·        Oversee a caseload of workers’ compensation indemnity claims managed by the TPA, ensuring timely and appropriate administration of benefits in accordance with applicable state laws

·        Conduct timely incident investigations, including communication with injured employees, supervisors, and witnesses

·        Perform root cause analysis on serious incidents and partner with loss control to recommend corrective actions

·        Provide ongoing claim oversight by reviewing file activity, reserves, and action plans; recommend strategies to drive optimal outcomes and reduce total cost of risk

·        Collaborate with adjusters, clients, and internal stakeholders to facilitate effective communication and claim progression

·        Evaluate and provide input on settlement strategies, reserve adequacy, and subrogation opportunities

·        Prepare for and participate in client claim reviews, audits, and stewardship meetings

·        Maintain clear, concise, and well-documented claim notes and action plans

OTHER DUTIES & RESPONSIBILITIES

·        Provide oversight and guidance to TPA and carrier partners to promote best practices and adherence to service expectations

·        Review policy coverage and confirm proper claim setup and jurisdictional handling

·        Recommend vendor utilization (e.g., nurse case management, IMEs, surveillance) and collaborate with adjusters to ensure appropriate deployment and cost control

·        Serve as a liaison between clients, carriers, and internal teams

MINIMUM QUALIFICATIONS

·        Minimum of 2 years of workers’ compensation claims experience, including at least 1 year handling lost-time claims at a carrier or TPA

·        Bachelor’s degree preferred, or equivalent combination of education and experience

·        Multi-state workers’ compensation experience preferred

·         Strong analytical, organizational, and communication skills

·        Proficiency in Microsoft Office

·        PEO experience a plus

·        Must be detail oriented

·        Demonstrated ability to collaborate, influence, and drive outcomes across multiple stakeholders

KEY COMPETENCIES

·        Ability to perform several tasks concurrently with ease and professionalism

·        Excellent written & verbal communication skills

·        Ability to work independently with minimal supervision

·        Must be able to handle confidential information

·        Effectively manages emotional or difficult customer situations, responds promptly to customer needs, solicits customer feedback to improve service, responds to requests for service and assistance, meets commitments

·        Focuses on building relationships, effectively resolving conflict, and maintaining confidentiality, tactfully approaches others, and treats others with respect and consideration regardless of status or position

·        Able to adapt to changes in the work environment, manages competing demands, change approach or method to fit the situation best, able to deal with frequent change, delay, or unexpected events

·        Identifies problems promptly, gathers and analyzes information skillfully, and develops alternative solutions

·        Follows instructions and responds to Management’s direction, takes responsibility for own actions, keeps commitments, commits to long hours of work when necessary to reach goals, completes tasks on time or notifies the appropriate person with an alternative plan; ability to work independently with minimal supervision

·        Maintains social, ethical, and organizational norms; firmly adheres to codes of conduct and ethical principles