Workers Compensation Analyst (Remote Eligible)

Workers' Compensation Analyst (Remote Eligible)

Position Summary

The Workers’ Compensation Analyst II supports the oversight and day-to-day administration of the Company’s workers’ compensation program. This role partners closely with the Third-Party Administrator (TPA), internal business partners, and external stakeholders to manage claims from intake through resolution, ensure compliance with applicable regulations, monitor claim performance, and support positive outcomes for associates and the organization. The Analyst provides recommendations regarding claims handling, trends, and process improvements while escalating complex or high-risk matters to the Workers’ Compensation Manager as appropriate.

Primary Duties & Responsibilities

• Manage all aspects of workers’ compensation claims administration from intake through resolution to ensure timely and appropriate delivery of benefits.

• Support oversight and ongoing monitoring of workers’ compensation claims in partnership with the Third-Party Administrator (Sedgwick).

• Track and coordinate new and existing associate injury claims to ensure timely medical care, appropriate claim handling, and accurate wage replacement payments.

• Monitor associate work status, return-to-work activity, and payroll alignment to help prevent underpayments, overpayments, and benefit discrepancies.

• Partner with HR, Payroll, Operations, Stores, Distribution Centers, Environmental Health & Safety (EH&S), and field leadership to support claim investigations, fact gathering, and resolution of claim-related issues.

• Review claim activity, documentation, reserves, settlements, and litigation status to ensure compliance with company standards and applicable regulatory requirements.

• Identify, prioritize, and escalate complex, high-exposure, litigated, or otherwise sensitive claims to the Workers’ Compensation Manager for review and direction.

• Participate in claim review meetings with TPAs, defense counsel, brokers, and other claim partners; document discussions and track follow-up actions.

• Assist with the assignment and coordination of defense counsel, including site visits, documentation requests, witness preparation, and litigation support activities.

• Coordinate with Legal and Employment Practices teams when incidents involve employee misconduct, policy violations, or other legal considerations.

• Provide claim handling recommendations to TPAs regarding investigations, reserves, settlements, and overall claim strategy within established authority levels and manager guidance.

• Track reserve activity, settlement discussions, approval needs, and claim outcomes to ensure accurate documentation and reporting.

• Respond to and support inquiries related to workers’ compensation, leave of absence programs, ADA accommodations, return-to-work matters, and related processes.

• Monitor and support administration of Critical Incident Pay to ensure accurate application, documentation, and compliance.

• Maintain accurate and timely claim documentation, system updates, and reporting within all claim management platforms and databases.

• Review claim and program data to identify trends, recurring issues, discrepancies, and opportunities for improvement.

• Provide observations and recommendations regarding process, policy, procedural, compliance, and operational improvements.

• Maintain confidentiality of medical, legal, payroll, and associate information in accordance with company policy and regulatory requirements.

• Support compliance with all applicable state, local, and federal workers’ compensation regulations and reporting requirements.

Preferred Qualifications & Experience

• Bachelor’s degree in Risk Management, Business Administration, Finance, Human Resources, Insurance, or a related field preferred; equivalent relevant experience may be considered.

• 3-5+ years of workers’ compensation, insurance, claims administration, risk management, or related experience.

• Experience supporting or administering a multi-state workers’ compensation program.

• Experience in retail, distribution, hospitality, or another high-volume, multi-location environment.

• Experience working directly with Third-Party Administrators (TPAs), insurance carriers, brokers, defense counsel, managed care providers, and other claims vendors.

• Working knowledge of workers’ compensation laws, benefit administration, claims management practices, and state-specific regulatory requirements.

• Familiarity with OSHA, FMLA, ADA/ADAAA, leave of absence programs, and the interaction of those programs with workers’ compensation claims.

• Working knowledge of medical and legal terminology related to occupational injury and workers’ compensation claims.

• General understanding of insurance adjusting practices and the workers’ compensation claim lifecycle.

• Experience reviewing payroll records, wage statements, average weekly wage calculations, wage replacement benefits, payroll…