Senior Workers Comp Claims Specialist

Senior Workers’ Compensation Claims Specialist

Key Purpose

The Senior Workers’ Compensation Claims Specialist is a seasoned professional responsible for prompt and expert management of workers’ compensation claims. This role includes effective coordination with the Third-Party Administrator (TPA), Legal, Risk Management, Health, Safety, Environmental & Quality (HSEQ), People & Culture (HR), and Leave of Absence (LOA) teams to support ISS Placemakers.

This is a fully remote position, with a preference for candidates based in Texas, Illinois, New York, or New Jersey.

Success Criteria

As a key member of the Risk Management team, you will oversee all workers’ compensation claims for the Eastern & Central regions of the U.S. and Canada, from inception to closure. The role requires strategic thinking, a focus on claim analysis, and the ability to facilitate communication, manage litigation, and oversee claim resolutions.

Responsibilities include:

Program Oversight

• Manage all aspects of the workers’ compensation program, including claims administration, litigation, and resolution.
• Collaborate with branch operations, HSEQ managers, P&C, LOA teams, TPAs, claims adjusters, and legal counsel.
• Serve as the primary contact for internal teams on workers’ compensation-related matters.

Claims Management

• Provide strategic oversight for TPA claims adjusters, ensuring efficient claims handling and cost mitigation.
• Review and approve claim reserve adjustments.
• Actively manage return-to-work initiatives for employees on temporary total disability (TTD).

Legal & Litigation Coordination

• Facilitate deposition and witness scheduling, document production, and settlement negotiations.
• Oversee TPA litigation strategies and work closely with outside defense counsel.

Compliance & Reporting

• Handle payroll reporting and payments for monopolistic states and Canada.
• Serve as administrator for monopolistic state and Canadian portals, providing rate statements and clearance certificates as needed.
• Ensure state-required postings are updated and distributed.

Training & Communication

• Provide workers’ compensation training to internal teams.
• Maintain and update intranet resources related to workers’ compensation processes.

Data & Analytics

• Coordinate and participate in regular claims reviews and stewardship meetings.
• Prepare and provide loss run reports, historical claim data, and insights for presentations, audits, and policy renewals.

Vendor & Partner Liaison

• Act as the main point of contact for TPA account managers, medical providers, and brokers.
• Review and process TPA invoices.

Other Duties

• Assist with various administrative and operational tasks related to workers’ compensation as assigned.

Qualifications & Skills

Experience:

• 10+ years managing workers’ compensation and lost time claims from inception to closure.

Skills:

• Exceptional verbal and written communication.
• Strong organizational skills and attention to detail.
• Ability to work independently with minimal supervision.
• Proficiency in Microsoft Office (Word, Excel, Outlook).

Education:

• Bachelor’s degree preferred.
• Active adjuster’s license is a plus but not required.

Physical Demands & Work Environment

• Comfortable working in a dynamic, fast-paced environment.
• Prolonged sitting at a computer for extended periods.
• Ability to lift up to 15 pounds.
• Periodic travel required by various modes of transportation.

ISS offers full time employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program based on employment status. The annual salary range for this position is $90000 per year - $100000 per year. Final compensation will be determined based on experience and skills and may vary from the range listed above.

As a global organization, ISS Group is committed to making the international community more resilient and just for all people. We encourage diversity and inclusion in their broadest terms, including ethnicity, race, age, gender, gender identity, disability, sexual orientation, religious beliefs, language, culture, and educational background. We look to lead our industry by example and to positively influence the market wherever we operate.