Sr. Worker's Compensation Program Specialist
$68k - $85kS&S Activewear
Job Description
ABOUT THE ROLE
The Senior Workers' Compensation Specialist serves as a key member of the Company's workers' compensation program and is responsible for the day-to-day administration, oversight, and coordination of multi-state workers' compensation claims and return-to-work activities. Working under the direction of the Workers' Compensation Manager, this position partners closely with Human Resources, Safety, Operations, third-party administrators (TPAs), medical providers, legal counsel, and team members to ensure timely claim resolution, effective return-to-work outcomes, regulatory compliance, and cost-effective claim management. The Senior Workers' Compensation Specialist functions as the primary operational lead for workers' compensation claims administration and program execution. This role independently manages complex claim activity, facilitates communication among stakeholders, identifies trends and opportunities for improvement, and supports organizational efforts to reduce overall trends or areas of concern.
This position is an individual contributor role with no direct reports.
COMPENSATION & SCHEDULE
Salaried: $68,000 - $85,000 (based on experience)
Bonus potential - 5%
Onsite Monday - Friday (standard business hours), Full-Time, Exempt
BENEFITS
We offer a comprehensive benefits package designed to support your life, health, and future. Benefits begin 0–90 days after hire and include Vacation, Personal, and Sick time; Medical, Dental, Vision, Life Insurance, and Disability coverage; Flexible Spending Accounts; and a 401(k) plan. You’ll also enjoy discounts on brand‑name apparel, fun employee events, and meaningful opportunities for growth and advancement. Join a company that invests in you from day one.
WHAT YOU WILL DO
Claims Management & Oversight
- Manage and oversee the day-to-day administration of multi-state workers' compensation claims.
- Serve as the primary internal contact for workers' compensation claim activity.
- Partner with TPAs, carriers, nurse case managers, and medical providers to monitor claim progress and ensure appropriate handling.
- Review claim status, reserves, action plans, and settlement recommendations and escalate concerns to the Workers' Compensation Manager as appropriate.
- Coordinate investigations of workplace injuries and ensure timely and accurate claim reporting.
- Monitor claim compliance with company standards, state regulations, and service expectations.
- Assist with resolution of complex, litigated, and high-exposure claims.
Return-to-Work & Accommodation Coordination
- Coordinate return-to-work and transitional duty programs across the organization.
- Collaborate with Human Resources, managers, Safety, and healthcare providers to facilitate early and safe return-to-work opportunities.
- Track employee work status restrictions and accommodations.
- Monitor duration and effectiveness of modified-duty assignments.
- Identify barriers to successful return-to-work outcomes and recommend solutions.
- Support compliance with applicable leave and accommodation programs as needed.
Vendor & Stakeholder Management
- Build and maintain productive working relationships with TPAs, carriers, medical providers, legal counsel, and other program partners.
- Facilitate communication among employees, managers, Human Resources, Safety, and Operations regarding claim activity.
- Respond to escalated workers' compensation questions and issues.
- Participate in claim review meetings and vendor performance discussions.
- Ensure vendors are providing timely and quality service in support of program objectives.
Reporting, Analytics & Cost Management
- Analyze claim trends, loss data, and program metrics.
- Prepare recurring reports, dashboards, and presentations for internal stakeholders.
- Monitor claim costs, reserve development, and closure rates.
- Identify opportunities to reduce workers' compensation costs and improve program performance.
- Support annual budgeting, forecasting, actuarial reviews, and insurance renewal activities.
- Maintain accurate program records and reporting systems.
Compliance & Program Administration
- Support compliance with applicable state workers' compensation regulations and reporting requirements.
- Maintain confidential team member medical and claim-related records.
- Assist with audits, regulatory requests, and documentation reviews.
- Ensure claim and injury documentation is complete and maintained according to company standards.
- Monitor program compliance and identify operational risks requiring management attention.
Continuous Improvement
- Recommend and implement process improvements that enhance service, efficiency, and claim outcomes.
- Participate in workers' compensation and safety initiatives designed to reduce workplace injuries and claim frequency.
- Assist with development of training materials and educational resources for managers and employees.
- Support special projects and other duties as assigned.
WHAT WE'RE LOOKING FOR
Required
- Bachelor's degree in Risk Management, Human Resources, Business Administration, Occupational Safety, Insurance, or a related field; equivalent experience may be considered.
- 5-7 years of progressive workers' compensation experience.
- Experience managing or coordinating multi-state workers' compensation claims programs.
- Working knowledge of workers' compensation claim handling practices, return-to-work programs, and claim cost containment strategies.
- Experience working with TPAs, insurance carriers, medical providers, and legal counsel.
- Strong analytical and problem-solving capabilities.
- Advanced Microsoft Excel proficiency and experience preparing reports and dashboards.
- Excellent verbal, written, and interpersonal communication skills.
- Ability to handle sensitive and confidential information.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
Preferred
- Experience in distribution, logistics, transportation, manufacturing, retail, or warehouse operations.
- Experience supporting large, multi-location workforces.
- Knowledge of OSHA recordkeeping requirements.
- Experience with Risk Management Information Systems (RMIS), claim management systems, and HRIS platforms.
- Professional certifications such as:
- Workers' Compensation Professional (WCP®)
- Associate in Claims (AIC)
- Associate in Risk Management (ARM)
- Certified Disability Management Specialist (CDMS)
- Workers' Compensation Insurance Professional (WCIP)
Key Competencies
- Workers' Compensation Claims Management
- Return-to-Work Program Administration
- Vendor & TPA Management
- Claim Cost Containment
- Multi-State Workers' Compensation Programs
- Regulatory Compliance
- Data Analytics & Reporting
- Risk Assessment
- Employee Relations
- Process Improvement
- Communication & Influencing Skills
- Stakeholder Management
- Problem Solving & Decision Making
- Confidential Information Management
- Cross-Functional Collaboration
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job.
WORKING ENVIRONMENT
This position operates in a professional office environment and may be structured as on-site, remote, or hybrid depending on business needs. This role requires the use of standard office equipment and collaboration with internal teams.
$68k - $85k
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