Analyst II Claims Adjuster - Workers' Compensation
Ahold Delhaize USA · Scarborough
Job description
About the role
Ahold Delhaize USA is hiring an experienced Analyst II Claims Adjuster to manage a caseload of incident-only, medical-only and lost-time Workers' Compensation claims across multiple jurisdictions. The role is an independent claims handler who ensures timely, compliant and cost-effective resolution while supporting injured associates through recovery and return to work. It is a hybrid position (1 day in person, 4 remote days) and can be based in offices in Salisbury, NC; Scarborough, ME; Quincy, MA or Carlisle, PA. Applicants must be authorized to work in the United States on a full-time basis.
Key responsibilities
- Manage an assigned caseload of incident-only, medical-only and lost-time Workers' Compensation claims in line with state laws and company policies.
- Investigate claims promptly to determine compensability, evaluate exposure and develop claim strategies.
- Negotiate and manage settlements within assigned authority, which varies with experience and competency.
- Manage medical treatment to shorten disability duration and promote safe, timely return to work.
- Work with Store Management, Distribution, Transportation and Human Resources on the Light Duty Return-to-Work program.
- Use nurse triage at injury intake and early claim stages to guide care and reduce unnecessary ER use.
- Work with PBM partners to monitor prescriptions and ensure they are injury-related and appropriate.
- Identify potential fraud indicators and escalate concerns per protocol.
- Communicate with associates, medical providers, attorneys and vendors while keeping strict confidentiality.
- Manage a book of WC claims aligned with departmental targets and share injury trends with the Safety team to support prevention and root-cause analysis.
Required profile
- Minimum 5 years of Workers' Compensation claims adjudication experience, including lost-time claims.
- Hands-on experience investigating and adjudicating claims, including statements and evidence, medical records, compensability, reserves and resolution.
- Active adjuster license(s) as required by jurisdiction, or ability to obtain one.
- Bachelor's degree or equivalent professional experience.
- Knowledge of Workers' Compensation statutes, claim handling practices and medical terminology.
Preferred qualifications
- Experience handling WC claims in multiple jurisdictions.
- Familiarity with retail, distribution or transportation operations.
- Working knowledge of FMLA, ADA and return-to-work coordination.
Salary ranges: $63,440-$95,160 for ME/NC/PA/SC positions and $72,880-$109,320 for IL/MA/MD/NY positions, depending on qualifications and experience.
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Published 2 days ago
Expires 1 month from now
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Ahold Delhaize USA
Scarborough
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