Job Description

Job Description

Job Description

Responsible for optimizing the end-to-end workers' compensation claims process, leveraging our Third-Party Administrator (TPA) partnership to accelerate resolution and minimize costs. This position is essential for cultivating strong, collaborative relationships with all internal and external clients, vendors, and industry peers, ultimately establishing Family Dollar's claims program as "Best in Class" through continuous cost reduction, enhanced outcomes, and unwavering support for injured associates.

Principal Duties and Responsibilities - Primary responsibilities listed in order of importance.

• Lead and supervise a team of internal workers' compensation claims analysts, ensuring consistent best practices and high performance.
• Oversee and strategically manage Third-Party Administrator (TPA) handled workers' compensation claims, driving initiatives to significantly reduce claim costs and improve overall outcomes.
• Grant authorization to the TPA for reserve adjustments and settlement authority, ensuring adherence to financial guidelines and optimal resolution strategies.
• Provide expert recommendations to the Director and VP regarding reserve adjustments and settlement strategies for complex, high-exposure claims, leveraging in-depth analysis and industry knowledge.
• Coordinate with Human Resources, Operations, and Legal departments to enhance claims outcomes, streamline processes, and facilitate effective communication.
• Champion injured associate support, collaborating with HR, Operations, and Legal to ensure comprehensive care and successful return-to-work programs.
• Act as a primary point of contact for field inquiries, providing timely and accurate information regarding associate status, temporary total disability (TTD) payments, HR status, and return-to-work progress.
• Lead and facilitate regular claims reviews with the TPA and conduct impactful roundtable discussions with Human Resources and Operations for stores and distribution centers to align strategies and determine crucial next steps.
• Collaborate closely with the Return-to-Work team and adjusters on policy adherence and associate status updates to ensure consistent application and support.
• Partner effectively with field management to implement and manage work accommodations, fostering a supportive environment for injured associates.
• Develop and execute robust claim resolution strategies for litigated matters, working in close collaboration with outside counsel to achieve favorable outcomes.
• Manage the discovery process for litigated workers' compensation claims, internally locating and producing accurate and timely responses to legal requests.
• Direct and approve assignments to outside counsel, ensuring appropriate legal representation and cost-effectiveness.
• Furnish comprehensive information to the TPA, including associate job functions, contact details, work status, and relevant records, to facilitate efficient claim processing.
• Gather and maintain accurate OSHA logs for monopolistic states, ensuring regulatory compliance.

Minimum Requirements/Qualifications - Summary of knowledge, experience and education required.

• Bachelor’s Degree

• 7+ years of multi state workers compensation (complex, litigated cases) experience with insurance carrier, third party administrator, corporate or insurance broker role in similar operating environment

• Strong analytical skills related to investigations, claims strategies and claims reviews

• Excellent written and verbal communications skills; ability to handle difficult situations

• Knowledge of medical terminology, medical treatment protocols, and legal proceedings

• Intermediate technology skills related to Excel, queries, and insurance company risk management information system

• Ability to work in fast paced team environment, handling multiple tasks and meeting deadlines

Desired Qualifications - Desired but not required.

• Professional Insurance Designation – SCLA, ARM, CPCU, etc.

• Retail experience a plus

• Human resources, OSHA, and/or Safety experience

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