Senior Claims Specialist

Location : Name

Green Bay Support Office

Position Type

Full-Time

Company Overview

ABOUT FESTIVAL FOODS:

We are a Wisconsin grocer that is committed to giving back to the communities it serves and providing guests with exceptional service and value. We operate +40 full-service supermarkets across the state of Wisconsin.

At Festival, people are at the top of our list. You’ll see it in everything from our daily interactions to how we treat our guests – even in our extensive associate benefits and programs.

Job Summary

Job Title:            Senior Claims Specialist

Reports to:        Workplace Safety Manager

 

The Senior Claims Specialist oversees the administration of first- and third-party worker’s compensation, foodborne illness, food injury, general liability, auto, and product/property claims. This role ensures timely and effective reporting, investigation, and resolution of claims while maintaining compliance with all regulatory requirements. The position plays a key role in reducing risk exposure, supporting injured associates, and protecting company assets.

Job Description

ESSENTIAL DUTIES AND RESPONISBILITIES

• Claims Program Leadership: Directs claims programs to ensure proper, efficient handling and accurate recordkeeping, contributing to loss forecasting and overall risk management.
• Claims Analysis and Reporting: Provides reporting of claims outcomes and insights to the Workplace Safety Manager, Asset Protection leadership, and other key stakeholders.
• Broker and Captive Collaboration: Maintains collaborative relationships with Broker agencies, and the Captive group to ensure seamless claims management.
• Claims Administration Oversight: Works with third-party claims administrators to review and authorize reserve adjustments as needed.
• Cross-Team Coordination: Coordinates with store and support teams to ensure claims information is complete, accurate, and effectively managed.
• Return-to-Work (RTW) Facilitation: Facilitates return-to-work processes for injured associates through modified duty programs.
• Claims Communication Management: Serves as the primary administrator for communication related to claims, interfacing with employees, management, physicians, attorneys, insurance adjustors, and other relevant parties.
• Safety Awareness and Notification: Notifies leadership of safety concerns and ensures proactive measures are taken.
• OSHA Compliance Management: Oversees all OSHA communication and reporting including OSHA 300 and 300A logs for compliance and reporting purposes.
• Nurse Triage Program Administration: Trains staff and implements documentation for Nurse Triage reporting procedures; develops and compiles Nurse Triage metrics for reporting.
• Quarterly Claims Review Support: Supports quarterly claims reviews by gathering and analyzing relevant information.
• Confidential File Maintenance: Maintains confidential files and ensures sensitive information is handled appropriately.
• Employee and HR Inquiry Response: Responds to and supports a large variety of inquiries from associates and HR regarding claims.
• Insurance Renewal Participation: Participates actively in annual insurance renewal processes.
• Honor Commitments: Regular, timely attendance in compliance with the work schedule, and adequate notice to find a replacement for occasional absences.
• Support the Team: Other duties as assigned.

 

ORGANIZATIONAL RELATIONSHIPS/CONTACTS

Organization Relationships:

• Reports directly to the Workplace Safety Manager
• Collaborates and partners with Store and Support Operations, Asset Protection and Human Resources to effectively manage the claims process

External Relationships:

• Partners with insurance brokers, claims advocates, and insurance representatives across all coverage lines to ensure proper claims handling and process oversight.

 

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 2+ years of professional experience in claims management,