Job Description

Sr Workers Compensation Claims Administrator

The Opportunity: Contribute To The Growth Of Your Career.

The Senior Workers Compensation Claims Administrator administrates and coordinates the investigation, reporting, payment defense, and subrogation of insurance claims processed through insurance companies. They assist in the implementation and coordination of Risk Management policy and projects through communication with Store, District and Regional Management. They maintain a pro-active approach in controlling cost of claims.

Who We Are Looking For: You.

• Manages lost time and medical only claims for designated states. Reviews claims for thorough investigation. Monitor claims to ensure that the TPA complies with TJX guidelines.
• Provides support to store management, injured worker, and field. Monitors ongoing medical treatment and follows for work restrictions. Process Workers’ Compensation coding.
• Administers the “Return to Work Program”. Coordinates injured workers return to work with store management, nurse case management and claims adjuster. Monitor the claim until injured worker has successfully to return to work.
• Monitors litigated files. Consults with defense to determine best case strategy to bring the case the resolution. Reviews settlement evaluations and determines if appropriate. Request settlement authority from management.
• Provides guidance on Risk Management policy and procedures. Identifies all high value claim and consults with Manager. Reviews reserves and allocated expenses from inception of the claim to conclusion for adequacy.
• Attend telephonic claims reviews for designated states. Performs special projects as assigned, but not limited to, assisting in required paperwork and documentation (i.e. Workers’ Compensation Posters, OSHA Survey Questions, etc.)
• Performs other duties as assigned

Qualifications

• 5+ years of experience managing workers compensation claims
• Bachelor’s degree or equivalent experience
• Analytical skills with strong attention to detail and follow up
• Ability to prioritize and effectively manage time
• Confidentiality is a must
• Ability to work independently and in a team environment
• Comfortable interpreting and communicating complex technical information with internal and external partners including legal counsel
• Experience with general insurance principles, Workers’ Compensation law, and litigation management

This position is hybrid requiring at least two days per week in the Marlborough, MA office and is not open to remote.

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