Spec II - Workers Compensation and Risk

Spec II - Workers Compensation and Risk at PODS Spec II - Workers Compensation and Risk at PODS in Dunedin, Florida Posted in about 21 hours ago.

Type:

full-time

Job Description:

The Workers' Compensation Claims and Risk Specialist II is primarily responsible for managing the full lifecycle of workers' compensation claims for the organization. This role partners directly with market managers, safety teams, human resources and our third-party administrator (TPA) to drive early claim resolution, support injured employees, and reduce total claim costs. The ideal candidate understands the physical demands and injury patterns unique to warehouse, driving, and delivery environments. This position supports and assists the corporate enterprise risk management program. Essential Duties And Responsibilities Claim Management & Oversight Serve as the primary point of contact for all workers' compensation claims, tracking and managing the full life cycle of worker injury claims to determine compensability. Acknowledge new claims promptly; evaluate initial submissions for accuracy, assess coverage, and document a claim summary with identified compensability issues. Conduct consistent, proactive follow-up with TPA adjusters to actively manage open claims, drive activity milestones, and develop strategies for early and appropriate resolution. Ensure adherence to state-specific workers compensation laws and assist with Occupational Safety and Health Administration (OSHA) reporting obligations. Coordinate with occupational health providers, nurse case managers, modified duty outsourcing partners, and internal invested parties to manage medical treatment and return-to-work programs and timelines. Determine case reserves and negotiate settlements within approved guidelines. Identify and escalate claims with potential for litigation, fraud, or excess exposure to the Director of Risk Management. Insurance & Risk Program Support Organize and maintain claims management files, insurance policies, and operational procedures on Microsoft Teams and TPA systems. Conducts loss management system training and provides data support for various internal end users. Assist with acquiring or gathering data and/or supporting documents for claims and leadership requests. Assist in gathering payroll, classification, and loss history documentation for annual workers' compensation insurance renewals and audits. Assist with certificates of insurance (COI) program for customers and vendors. May perform other duties in support of the risk management department.

MANAGEMENT & SUPERVISORY RESPONSIBILTIES

Typically reports to Management. Direct supervisor job title(s) typically include: Director-Risk Management Job is not directly responsible for managing other employees (e.g., hiring/termination and/or pay decisions, performance management). This position may have mentoring responsibilities i.e. (temporary help, or part time employee).

JOB QUALIFICATIONS

Essential Skills, Abilities, and Example Behavior(s)

DELIVER QUALITY RESULTS

Able to deliver top quality service to all customers (internal and external); Able to ensure all details are covered and adhere to company policies; Able to strive to do things right the first time; Able to meet agreed-upon commitments or advises customer when deadlines are jeopardized; Able to define high standards for quality and evaluate products, services, and own performance against those standards

TAKE INITIATIVE

Able to exhibit tendencies to be self-starting and not wait for signals; Able to be proactive and demonstrate readiness and ability to initiate action; Able to take action beyond what is required and volunteers to take on new assignments; Able to complete assignments independently without constant supervision

BE INNOVATIVE / CREATIVE

Able to examine the status quo and consistently look for better ways of doing things; Able to recommend changes based on analyzed needs; Able to develop proper solutions and identify opportunities

BE PROFESSIONAL

Able to project a positive, professional image with both internal and external business contacts; Able to create a positive first impression; Able to gain respect and trust of others through personal image and demeanor

ADVANCED COMPUTER USER

Able to use required software applications to produce correspondence, reports, presentations, electronic communication, and complex spreadsheets including formulas and macros and/or databases. Able to operate general office equipment including company telephone system

JOB QUALIFICATIONS

Education & Experience Requirements Education Minimum of Bachelor's degree or equivalent related experience 2 - 4 years of professional experience required Certification, licensure or professional designation in workers compensation required Experience/Skills High work volume experience required Risk or insurance experience preferred Transportation risk experience a plus Knowledge of claims handling techniques a plus Proficient with MS suite of products and computer technology Analytical skills with follow-up and sense of urgency Organizational, time management and prioritization skills Interpersonal, written and oral communication skills