Workers Compensation and Risk

Workers Compensation and Risk

PODS - 3.0

Clearwater, FL Job Details Full-time 1 day ago Qualifications Workers' compensation law Stakeholder engagement Handling insurance claims Data interpretation Workers' compensation claims Productivity software Technical Proficiency Negotiation Full Job Description

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

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, in at least one State (e.g., CPCU, ARM, AIC, or Workers' Compensation certification) required Experience handling high-volume and high-complexity claims environments required #app2