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Sr Workers Comp Claims Specialist

Date Posted: Jul 25, 2026
Yearly: USD - USD

Job Detail

  • location_on
    Location Cambridge, Massachusetts, United States of America
  • desktop_windows
    Job Type: Permanent
  • schedule
    Shift:
  • analytics
    Career Level:
  • group
    Positions:
  • calendar_view_day
    Experience:
  • male
    Gender: No Preference
  • school
    Degree:
  • calendar_month
    Apply Before: Oct 23, 2026

Job Description

Overview

BJ's Club Support Center Job OpportunityJoin our team of more than 34,000 team members, supporting our members and communities in our Club Support Center, 235+ clubs and eight distribution centers. BJ's Wholesale Club offers a collaborative and inclusive environment where all team members can learn, grow and be their authentic selves. Together, we're committed to providing outstanding service and convenience to our members, helping them save on the products and services they need for their families and homes.The Benefits of Working at BJ's BJ's pays weekly Eligible for free BJ's Inner Circle and Supplemental membership(s) Generous time off programs to support busy lifestyles o Vacation, Personal, Holiday, Sick, Bereavement Leave, Jury Duty Benefit plans for your changing needs o Three medical plans , Health Savings Account (HSA), two dental plans, vision plan, flexible spending eligibility requirements vary by position medical plans vary by locationJob Summary:Execute and implement strategies that will result in reducing claim cost in the workers' compensation arena. The scope includes: ensuring injured team members receive the best possible care, provides oversight of third party claims administrator (TPA) to achieve optimal financial results; partnering with clubs/DC's and internal partners to ensure that the workers' compensation benefits are administered according to State regulations; provide training on workers' compensation benefits; liaising with all external stakeholders including insurance carriers and outside counsel; accurately setting and monitoring the claim reserves; and proactively monitoring claim best practices and new risk management initiatives to reduce claim severity and costs.Major Tasks, Responsibilities, and Key Accountabilities:Performs claims oversight of a third-party claim administrator (TPA). This includes ensuring TPA best practices are executed; responding to TPA requests for team member information; providing wage information, consults with outside counsel, processes claim billing and funding requests.Partners with TPA to steer claims towards resolution, provides insight to defense counsel and ensures there is an efficient use of BJ's resources. Reviews open claims to ensure carrier/excess carrier reporting, determines compensability, scheduling of IME's, medical case management, surveillance, subrogation and litigation tasks are completed timely. Utilize risk information system to track claims progress.Provides direction to ensure the accurately setting monitoring of claim reserves, including written summaries. Approves and suggests amount for reserves and settlements up to authority level.Serves as the liaison to Clubs, DC's, Member care, Benefits to ensure RTW, LOA and general inquiries are answered. Provide workers' compensation training to educate clubs/internal partners.Manages the data flow through a central Outlook inbox between risk, benefits, HR, LOA, defense counsel and TPA.Identifies claim trends and provides recommendations to the Claims Manager and Director, Risk Management, and Insurance for decreasing the frequency of claims.Partners with Asset Prevention/Safety on team member claims trend information and any required OSHA reporting.Participates in a review of the performance of TPA's with respect to file reviews, best practice audits, clinical consultation, service providers and claims action plans.Participates in department projects and other tasks.After hours coverage, including weekends, as needed.Job Qualifications:Bachelor's Degree preferred3+ years claim experience requiredPreferred: Insurance industry claim designationAbility to multi-task and pivotHas in-depth knowledge in own discipline and basic knowledge of related disciplinesPreferred: knowledge of Texas non-subscriber claims handlingSolves complex problems; takes a new perspective on existing solutionsOral and written communications skillsCustomer service skillsAbility to identify and seeks needed information/resea

Key responsibilities

Not specified in the original listing.

Required skills

  • Insurance & Superannuation

What the company offers

Not specified in the original listing.

Skills Required

Company Overview

Kentucky, United States of America

BJ's Wholesale Club is committed to delivering value and convenience to its members. With a large team across many locations, they focus on helping families save on essential goods and services. Read More

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