Seeking an experienced and adaptable Workers' Compensation Claims Administrator on contract to oversee and manage workers' compensation claims across internal employees and a geographically large workforce. This critical role requires a proactive, detail-oriented professional who thrives in a high-volume, multi-tasking environment and can balance the needs of both internal stakeholders and external clients.
The ideal candidate will have extensive experience managing multi-state claims, investigating incidents, and working collaboratively with cross-functional teams to mitigate risk, control costs, and improve outcomes. Strategic thinking, the ability to prioritize in real-time, and a willingness to raise concerns and challenge issues when necessary are key qualities for success in this role.
Key Responsibilities:
Claims Administration & Oversight
- Manage the end-to-end process of workers' compensation claims, including claim intake, investigation, reporting, follow-up, and resolution.
- Communicate effectively with injured workers, insurance carriers, third-party administrators (TPAs), healthcare providers, attorneys, clients, and internal stakeholders to drive claim progression and closure.
- Monitor claims status, set reserves, track expenses, and actively pursue strategies to reduce overall claim costs and experience modification rates.
- Ensure timely and accurate reporting in accordance with state-specific requirements.
Investigation & Analysis
- Conduct or coordinate thorough investigations for workplace incidents and injuries, collecting witness statements, documentation, and job site information.
- Assist in root cause identification and collaborate with safety teams to develop corrective actions when necessary.
- Identify emerging risks, trends, or recurring issues and develop insights that inform proactive safety and claims management strategies.
Strategic Claims Management
- Prioritize and juggle multiple open claims across different states and jurisdictions, ensuring compliance and timely resolution.
- Proactively identify or challenge questionable claims or treatment plans when appropriate, working to ensure fair and accurate claim outcomes.
- Evaluate return-to-work options and light-duty opportunities with clients and internal HR/safety teams.
Client and Internal Collaboration
- Provide claims-related support and guidance to internal departments, branch locations, and external clients.
- Present data and claims summaries to management and client partners, including trends, risk factors, and cost-saving opportunities.
- Partner with sales, operations, and safety teams to address job placement risks and injury prevention opportunities.
Qualifications:
- 3-5 years of hands-on experience in workers' compensation claims management, preferably in a light industrial sector.
- Strong working knowledge of multi-state workers' compensation laws and procedures.
- Experience conducting incident investigations and understanding root cause analysis.
- Demonstrated ability to manage high volumes of claims while maintaining attention to detail and prioritizing effectively.
- Exceptional verbal and written communication skills; able to communicate complex issues clearly and diplomatically.
- Skilled in identifying risk trends, analyzing data, and presenting actionable insights to stakeholders.
- Proficient in Microsoft Office Suite; experience with claims management systems a plus.
- Ability to work independently and take initiative in a fast-paced, high-volume environment.
Preferred Attributes:
- Strategic and analytical mindset with a proactive approach to problem-solving.
- Comfortable pushing back professionally on claims-related issues when necessary.
- Collaborative and team-oriented; able to work cross-functionally with HR, Safety, Operations, and client contacts.
- Bilingual (Spanish/English) a plus.