Analyst II Claims Adjuster

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which also includes five leading omnichannel grocery brands – Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Ahold Delhaize USA associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.

Scarborough, ME

Ahold Delhaize USA

<p class="p1"><strong><br />Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which also includes five leading omnichannel grocery brands &ndash; Food Lion, Giant Food, The GIANT Company, Hannaford and Stop &amp; Shop. Ahold Delhaize USA associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more.<br /><br /></strong>Join our Talent Community to stay updated on opportunities with Ahold Delhaize USA. You&rsquo;ll be the first to know about new positions that match your career aspirations. To join, click here: <strong><a href="https://aholddelhaizeusa.careerswithus.com/join-our-talent-community" target="_blank" title="Talent Community - Ahold Delhaize USA (careerswithus.com)" rel="noopener noreferrer">Talent Community - Ahold Delhaize USA (careerswithus.com)</a></strong>.&nbsp;</p> <p class="p2">&nbsp;</p> <p class="p1"><strong><a href="https://aholddelhaizeusacareers.appvault.com/create" target="_blank" title="Talent Community " rel="noopener noreferrer"></a><br /></strong></p> https://www.adusa.com/

keywords: position summary,position details,schedule,authorized to work in the u.s.,manage,support,communication,coordinate,investigate,financial & operational impact,qualifications,experience,skills,preferred

Full Time

535968

Overview: The Analyst II role is an experienced adjusting position responsible for managing a caseload of incident-only, medical-only, and lost-time Workers' Compensation claims across multiple jurisdictions. This role functions as an independent claims handler, ensuring timely, compliant, and cost-effective claim resolution while supporting injured associates through recovery and return-to-work.<br /><br />Analysts collaborate closely with internal partners and vendors and escalate complex issues to Specialists, Analyst III resources, or the Team Manager as appropriate. The role does not have direct people-management responsibility.<br /><br /><strong>This position follows a hybrid schedule (1 day in-person at a core location, 4 remote days). This position can be based in one of our offices located in Salisbury, NC, Scarborough, ME, Quincy, MA and Carlisle, PA.</strong><br /><br /><strong>Applicants must be currently authorized to work in the United States on a full-time basis.</strong>
Responsibilities: <div class="full-text ng-binding"> <ul> <li>Manage an assigned caseload of incident-only, medical-only, and lost-time Workers' Compensation claims in compliance with applicable state laws and company policies.</li> <li>Conduct timely investigations to determine compensability, evaluate exposure, and develop appropriate claim strategies.</li> <li>Negotiate and manage settlements within assigned authority. Authority levels vary based on experience and demonstrated competency and align with corporate guidelines.</li> <li>Actively manage medical treatment to minimize disability duration and promote safe, timely return-to-work.</li> <li>Partner closely with Store Management, Distribution, Transportation, and Human Resources to support participation in the Light Duty RTW Program.</li> <li>Utilize nurse triage services at injury intake and during early claim activity to ensure appropriate care direction and reduce unnecessary emergency room utilization.</li> <li>Coordinate with PBM partners to monitor prescriptions and ensure medications are injury-related and appropriate.</li> <li>Identify potential fraud indicators and escalate concerns in accordance with established protocols.</li> <li>Communicate clearly and professionally with associates, medical providers, attorneys, and vendors while maintaining strict confidentiality.</li> </ul> <br /><strong>Financial &amp; Operational Impact</strong><br /> <ul> <li>Manages an assigned book of WC claims aligned with departmental performance targets.</li> <li>Works closely with the Safety team to enhance injury prevention and improve claim outcomes by sharing injury trends, supporting root-cause analysis, and reinforcing early intervention strategies focused on reducing lost time and claim escalation.</li> </ul> </div>
Requirements: <ul> <li>Minimum 5 years of Workers' Compensation claims adjudicating experience, including lost-time claims.</li> <li>Requires extensive, hands-on experience investigating and adjudicating claims, including gathering statements and evidence, reviewing medical records, determining compensability, establishing reserves, and managing claims through resolution.</li> <li>Active adjuster license(s), as required by jurisdiction, or ability to obtain.</li> <li>Bachelor's degree or equivalent professional experience.</li> <li>Working knowledge of Workers' Compensation statutes, claim handling practices, and medical terminology.</li> </ul> <br /><br /><strong>Preferred Qualifications</strong><br /> <ul> <li>Experience handling Workers' Compensation claims in multiple jurisdictions.</li> <li>Familiarity with retail, distribution, or transportation operations.</li> <li>Working knowledge of FMLA, ADA, and return-to-work coordination.</li> </ul> <br /><br /><strong>Skills &amp; Abilities</strong><br /> <ul> <li>Strong negotiation, analytical, and problem-solving skills.</li> <li>Effective communication skills with internal and external partners.</li> <li>Ability to manage competing priorities in a fast-paced, high-volume environment.</li> <li>Demonstrated adaptability and willingness to grow technical claim expertise.</li> </ul> <br /><br /><strong>ME/NC/PA/SC Salary Range:</strong> $63,440-$95,160<br /><br /><strong>IL/MA/MD/NY Salary Range:</strong> $72,880 - $109,320<br /><br />Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws.