Risk & Claims Manager

Fessler & Bowman Inc•Holly, MI

1d•Hybrid

About The Position

The Risk & Claims Manager is responsible for ensuring that every F&B team member with an active workers’ compensation claim or a work restriction is managed with care, consistency, and discipline to protect both the individual and the organization. This role is accountable for managing claims from intake through closure, facilitating modified duty placements, tracking work restrictions, coordinating documentation with carriers, responding to incidents, managing leaves, supporting field supervisors, and reporting to the Director of Risk Management. The goal is to ensure injured team members have a clear point of contact, modified duty placements are successful, and claims are managed effectively to achieve the right outcomes.

Requirements

5+ years of workers’ compensation claims management experience with active caseload across multiple states
Demonstrated return-to-work and modified duty program coordination in a field-intensive environment
Working knowledge of the FMLA, ADA, and workers’ compensation intersection
Advanced experience with WC carrier or TPA coordination including treatment authorization and adjuster communication
Advanced proficiency with claims management systems and case file documentation standards
Ability to communicate clearly and compassionately with injured team members while maintaining documentation discipline.
Strong knowledge of employment laws, compensation structures, and benefits administration.

Nice To Haves

Bilingual (Spanish-speaking) preferred.

Responsibilities

Manages all active workers’ compensation claims from intake through closure.
Serves as the primary point of contact for injured team members, ensuring they understand the claims process, have access to appropriate medical care, and are treated with dignity.
Monitors claim status, treatment progress, and work status updates, communicating proactively with injured team members.
Leads F&B’s return-to-work program with disciplined placement.
Identifies modified duty opportunities for team members with work restrictions and coordinates placement with supervisors and operational leaders.
Develops and maintains modified duty job offerings and follows up to ensure placements are working and restrictions are honored.
Maintains accurate, current records of all team members with active work restrictions, tracking parameters, expiration dates, and accommodation status.
Communicates restriction changes to supervisors and HR promptly.
Coordinates with HR on ADA and FMLA intersections with workers’ compensation leaves.
Maintains complete and accurate claim files and coordinates with carriers and TPAs.
Ensures incident reports, medical records, and correspondence are organized and current in the claims management system.
Coordinates with the workers’ compensation carrier or TPA on claim status, treatment authorizations, and adjuster communications.
Provides the Director of Risk Management with regular claim status summaries and emerging exposure flags.
Coordinates F&B’s response to workplace injuries from the moment of report, ensuring accurate documentation and prompt medical care access.
Partners with the Safety team on incident investigation.
Coordinates workers’ compensation leave with HR-administered leave programs, ensuring FMLA is designated concurrently when applicable.
Communicates leave status and return dates to HR and payroll.
Serves as the primary resource for field supervisors managing team members with active claims or restrictions.
Provides clear, timely guidance to field supervisors on managing restricted team members.
Provides the Director of Risk Management with regular reporting on the active claims portfolio, including claim counts, status summaries, and return-to-work metrics.
Supports the Director’s carrier meetings, reserve reviews, and program stewardship activities.
Identifies patterns in claim frequency, duration, or injury type that suggest operational or safety interventions and escalates them.