Workers' Compensation Analyst III Claims Adjuster

Category/Area of Expertise: Risk Management & Insurance Job Requisition: 487303 Address: USA-MA-Quincy-1385 Hancock Street Store Code: Claims Management (5157503) Position Summary The Analyst III role is a senior-level adjusting position responsible for the management of the organization’s most complex, high-dollar, and litigated Workers’ Compensation claims. This role functions as a technical expert and trusted advisor, providing advanced claim strategy, mentoring to developing analysts, and backup support to the Team Manager as needed. The role does not have direct people‑management responsibility. Our flexible/hybrid work schedule includes 1 in‑person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full‑time basis. Principle Duties & Responsibilities Manage a complex caseload of high-dollar and litigated Workers’ Compensation claims in compliance with applicable state laws, Medicare regulations, and company policies. Conduct in‑depth investigations, develop comprehensive claim strategies, evaluate exposure, and establish and maintain appropriate reserves. Exercise settlement and negotiation authority on individual claims up to $175,000, in accordance with corporate authority guidelines. Assign, direct, and manage external resources including defense counsel, investigators, and rehabilitation vendors to drive timely, cost‑effective claim resolution. Represent the organization in mediations, hearings, and other litigation‑related proceedings as the technical subject matter expert. Serve as a technical resource to Company leadership, Human Resources, Safety, and other partners regarding complex claim issues, trends, and risk exposure. Lead and participate in departmental and cross‑functional projects, including initiatives focused on litigation strategy, process improvement, compliance, cost containment, training, and system enhancements. Analyze data and claim outcomes to support project recommendations and help drive continuous improvement. Mentor and coach assigned Analysts to strengthen claims fundamentals, time management, and litigation handling skills, preparing them for progression to higher-level roles. Provide coverage and decision‑making support in the absence of the Team Manager, including escalation guidance and file strategy review. Communicate clearly and professionally with internal stakeholders, claimants, attorneys, and vendors while maintaining strict confidentiality. Financial & Operational Impact Manages a significant book of WC claims with financial exposure of approximately $100M. Identifies loss trends and communicates insights to Safety and leadership to support injury prevention and cost‑containment initiatives. Serves as a primary escalation point for complex claim issues impacting associates, vendors, and the organization. Basic Qualifications Minimum 10 years of progressively responsible experience handling complex, high-dollar, litigated Workers’ Compensation claims. Active adjuster license(s), as required by jurisdiction (or ability to obtain). Bachelor’s degree or equivalent professional experience. Advanced knowledge of Workers’ Compensation statutes, legal procedures, Medicare compliance, and medical terminology. Demonstrated ability to mentor and coach peers in claims best practices. Preferred Qualifications Professional claims or risk management designation (AIC, ARM, CPCU, or similar). Experience supporting self‑insured programs, captives, or complex risk structures. Legal or litigation support background related to Workers’ Compensation (formal legal degrees not required). Skills & Abilities High-level negotiation, analytical, and strategic thinking skills. Strong communication and influence skills across all organizational levels. Ability to manage competing priorities in a fast‑paced, high‑exposure environment. Demonstrated adaptability and comfort operating as a senior technical authority. ME/NC/PA/SC Salary Range: $75,040 – $112,560 IL/MA/MD/NY Salary Range: $86,320 – $129,480 Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws. #J-18808-Ljbffr Loyalty360