SpartanNash is a value-added wholesale grocery distributor — supplying more than 2,100 independent grocery retail locations throughout the United States — as well as a grocery retailer, with more than 155 corporate supermarkets in nine states. We also serve the military community through our MDV division; in addition to offering premier fresh produce distribution and fresh food processing through Caito Foods and third-party logistics through BRT.
At SpartanNash, relationships matter, and our Corporate team takes that sentiment to heart in the way we work as one totally aligned team, support and respect each other and share the highest standards of excellence. We’re always looking for the next great idea or a new way to approach a challenge, and we collaborate and innovate to achieve our goals.
A day in the life of the Claims Specialist is never the same but, in this role, you will be responsible to process, coordinate and support the Risk Management department in self-administration of workers compensation claims, general and auto liability claims, and property and casualty claims. Verify, analyze and document claims to ensure proper, accurate and timely processing of claims and review claim reserves. Provide information, reporting and data to management team, actuarial and/or states/federal government as necessary.
What You’ll Do:
•Responsible to administer workers compensation claims, general and auto liability claims, and property and casualty claims for insured and self-insured states either directly or through third party administrator (TPA). Investigate and evaluate claims to ensure settlement is in accordance with company policies and guidelines and state and federal regulations. Analyze and determine value of claims (i.e. time off, cost of claim, etc.)
•Maintain claims documentation and files within the risk management database including allocation, wage calculation, explanation of benefits, OSHA information, etc. Assist with the preparation and submission of mandatory state and federal claims (i.e., OSHA) reports and notifications.
•Work with internal and external customers to coordinate the administration and process of general liability and auto liability claims (i.e. contact customers, inform on medical treatment options, send information to TPA, train on safety needs, request information on damage/accidents/property and work with claims adjuster regarding cost of damage, etc.) and address claim related inquiries and issues.
•Support the process of claims investigation to confirm coverage and determine liability, compensability, and damage. Assess policy coverage and highlight issues; determine reserve requirement and suggest reserves adjustment, as necessary and ensure company's claim reserves are adequate.
•Prepare and reconcile department reports for outstanding payments, uncollectible claims and auto-payment recoveries, etc.; analyze claims activity and prepare financial and claims reporting; provide summary analysis for management review.
•Assist in the resolution of workers compensation related issues including claims management, litigation management and resolution/outcome management. Responsible to mediate first level disputes among injured workers, employers, insurance brokers and claim administrators accordingly.
•Assist with educating and/or training associates and management on the execution of claim management programs and processes.
•Maintain effective working relationships with internal and external contacts (i.e. third-party administrators, associates, customers, management, legal counsel, medical personnel, etc.).
•Participate in department projects such as completing applications and transactions from outsourcing to in-house/self-insured claims management.
•Maintain current knowledge of legal regulations, industry trends and best Risk Management/claims processing practices; make recommendations to improve current programs and processes and to ensure company legal compliance.
Sound Like You? Here’s what you’ll need:
•Associate degree (Required) Claims (AIC), Risk Management, Insurance or related area.
•Licenses and Certifications: MI Property/Casualty License (Preferred); Property & Casualty License (Required)
•Three (3) years in claims processing, claims investigation or related area within an office environment.
•Strong written and verbal communication skills; ability to interact with internal and external contacts. Strong organizational, problem solving, prioritization and attention to detail skills.
•Good analytical and negotiation skills to effectively review and administrator claims process. Working knowledge in risk management and claims processing and experience with claims database administration (i.e., STAR).
•Must understand state laws and regulations affecting insurance practices and familiarity with medical terminology, legal processes, general insurance policy coverage, claims investigation techniques, medical and legal aspects of claims.
•Proficiency in MS Office (Word and Excel)
SpartanNash is proud to take care of the people who take care of our business through our robust and competitive Total Rewards benefits package. !
SpartanNash is a certified Military-Friendly employer. Veterans are encouraged to apply!
Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.