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Risk Solutions- Claims Adjuster

Responsibilities:

As a Risk Solutions Representative, you'll manage and administer Risk Solutions Programs with the guidance of Risk Leadership: Work Injury Benefit Plan, Return-to-Work Benefit Plan, Premises and Products Liability Program, and Loss Prevention Litigation. You'll handle claims and conducts litigation management. Facilitate safety initiatives with assigned stores / locations within OSHA regulations.

Once you're eligible, you'll become an Owner in the company, so we're looking for commitment, hard work, and focus on quality and Customer service. 'Partner-owned' means our most important resources-People-drive the innovation, growth, and success that make H-E-B The Greatest Omnichannel Retailing Company.

Do you have a:
HEART FOR PEOPLE... connect with Partners?
HEAD FOR BUSINESS... ability to understand financials?
PASSION FOR RESULTS... facilitate safety initiatives?

We are looking for:

Bachelor's degree or comparable formal training, certification, or work experience
2+ years related experience
2-5 years claims handling experience (case management involving medical, vocational, subrogation / recovery, return to work program, etc.)
Valid Texas driver license, no DUI, and no more than 2 moving violations in last 2 years

What is the work?

Handles daily claims activity, including work injury cases, Return-to-Work Benefit Program, premises liability, product liability, loss prevention attorney‑represented claims, and OSHA compliance tracking.
Conducts investigations on all types of claims and RTW cases and provides recommendation for best course of action
Reviews and interprets existing, new or proposed OSHA and other federal and state regulations, updates to department staff as necessary
Investigates and documents hazard reviews; analyzes, evaluates and presents recommendations
Coordinates litigation case management to ensure cost containment; attend trials when needed, reports on trial to management, ensures clear and concise communication between defense attorney and management
Manages incident reports and determine appropriate action plan
Communicates with all partners, customers and other third parties who have filed an incident report to determine an appropriate action plan and to provide the best possible customer service
Reviews reports, makes initial contact with partner, determines eligibility for benefits on work injuries, and administers all benefits due in accordance with the with the provisions of the Work Injury Benefit Plan, including coordination of the Return to Work (RTW) Program
Facilitates subrogation / recovery efforts from third parties responsible
Continuously reviews, sets and monitors reserves to reflect appropriate levels of exposure
Reviews and approves payments on all cases within assigned authority
Ensure adequate communication and resolution on attorney represented or litigated cases
Negotiates and diffuses claims with third parties and plaintiff Attorneys
Serves as corporate representative, witness, etc. as necessary
Facilitates property claims, work injury and general liability
Instills a safety culture and supports all safety initiatives
Demonstrates proficiency in training of Risk Solutions initiatives
Performs other functions pertinent to this job as assigned
Creates, runs, analyzes, and communicates incident trends reports for Operations Leadership

What is your background?

Bachelor's degree or comparable formal training, certification, or work experience
2+ years related experience
2-5 years claims handling experience (case management involving medical, vocational, subrogation / recovery, return to work program, etc.)
Current 'All-Lines' Claims Adjuster license through the Texas Department of Insurance
Valid Texas driver license, no DUI, and no more than 2 moving violations in last 2 years

Do you have what it takes to be an H-E-B Risk Solutions Representative?

Ability to interface with regulatory agencies, division and corporate staff, professional associations and other organizations
Excellent customer service skills
Excellent telephone skills
Bilingual preferred (English & Spanish)
Moderate PC skills, including Microsoft Office Software and a Claims Management System
Working knowledge of PPO utilization, medical terminology, etc.
Understanding of project management process

Can you...