Spec III Workers Compensation and Risk

JOB SUMMARY

The Workers Compensation and Risk Specialist III is responsible for managing complex workers compensation claims and serving as a subject matter expert for the organizations workers compensation program. This role leads high-exposure claim strategies partners cross-functionally to reduce risk and drives continuous improvement in claim outcomes cost containment and employee experience. The Specialist III also plays a key role in enterprise risk management initiatives and mentors junior team members.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Claims Management & Strategic Oversight

Manage the full lifecycle of workers compensation claims including complex high-exposure litigated and multi-jurisdictional cases

Serve as escalation point for challenging claims providing guidance on compensability reserves and settlement strategy

Develop and implement claim strategies to optimize outcomes minimize risk exposure and control total cost of risk

Lead regular claim reviews with TPAs carriers and internal stakeholders to ensure proactive claim handling

Establish appropriate reserves and approve settlements within expanded authority guidelines

Identify trends root causes and opportunities for systemic improvements in claim handling

Business Partnership & Program Leadership

Act as a trusted advisor to HR Operations Safety and Leadership on workers compensation matters

Partner with safety teams to identify injury trends and implement prevention strategies

Lead return-to-work program effectiveness including modified duty strategy and vendor optimization

Ensure compliance with all state workers compensation laws and OSHA requirements

Provide guidance during audits litigation and regulatory inquiries

Risk Management & Continuous Improvement

Support and influence enterprise risk management initiatives related to occupational risk

Analyze claim data and produce insights to inform leadership decision-making

Recommend process improvements automation opportunities and policy enhancements

Participate in insurance renewal strategy including providing loss data analysis and insights

Mentorship and Leadership

Mentor and provide guidance to Specialist I and II roles

Support onboarding and training of new team members

Lead or contribute to cross-functional projects and initiatives

MANAGEMENT & SUPERVISORY RESPONSIBILTIES

Typically reports to Director Risk Management

No direct reports but provides functional leadership and mentorship to junior team members

JOB QUALIFICATIONS: Essential Skills Abilities and Example Behavior(s)

DELIVER QUALITY RESULTS: Able to deliver top quality service to all customers (internal and external); Able to ensure all details are covered and adhere to company policies; Able to strive to do things right the first time; Able to meet agreed-upon commitments or advises customer when deadlines are jeopardized; Able to define high standards for quality and evaluate products services and own performance against those standards

TAKE INITIATIVE: Able to exhibit tendencies to be self-starting and not wait for signals; Able to be proactive and demonstrate readiness and ability to initiate action; Able to take action beyond what is required and volunteers to take on new assignments; Able to complete assignments independently without constant supervision

BE INNOVATIVE / CREATIVE: Able to examine the status quo and consistently look for better ways of doing things; Able to recommend changes based on analyzed needs; Able to develop proper solutions and identify opportunities

BE PROFESSIONAL: Able to project a positive professional image with both internal and external business contacts; Able to create a positive first impression; Able to gain respect and trust of others through personal image and demeanor

ADVANCED COMPUTER USER: Able to use required software applications to produce correspondence reports presentations electronic communication and complex spreadsheets including formulas and macros and/or databases. Able to operate general office equipment including company telephone system

JOB QUALIFICATIONS: Education & Experience Requirements

Skills and Competencies

Advanced knowledge of workers compensation laws claims handling and injury management

Strong analytical and problem-solving skills with ability to interpret complex data

Demonstrated negotiation and influencing skills in high-stakes situations

Ability to manage ambiguity and lead through complex claim scenarios

Strong communication and stakeholder management skills

Advanced proficiency in claims systems RMIS and Microsoft Office tools

EDUCATION & EXPERIENCE

Bachelors degree or equivalent experience required

58 years of workers compensation or risk management experience required

Professional certification (e.g. CPCU ARM AIC or Workers Compensation certification) preferred

Experience handling high-volume and high-complexity claims environments required