SeniorFull TimeEN
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 organization’s 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
• Bachelor’s degree or equivalent experience required
• 5–8 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
