Risk & Claims Manager

Fessler & Bowman Inc•Holly, MI

2d•Hybrid

About The Position

The Risk & Claims Manager is responsible for managing all active workers’ compensation claims and work restrictions for Fessler & Bowman (F&B) team members. This role ensures that injured team members have a dedicated point of contact throughout their claim process, facilitates modified duty placements to help team members return to work sooner, and manages claim documentation and carrier coordination. The position also involves coordinating workers’ compensation leave with HR-administered leave programs and supporting the Director of Risk Management with reporting and program oversight. The goal is to manage claims with care, consistency, and discipline to protect both the individual team member and the organization, ensuring optimal outcomes for all parties involved.

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 field supervisors and operational leaders.
Develops and maintains modified duty job offerings across F&B’s operational functions.
Maintains accurate, current records of all team members with active work restrictions, tracking parameters, expiration dates, and physician instructions.
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, treatment authorizations, and correspondence are organized and current in the claims management system.
Coordinates with the workers’ compensation carrier or TPA on claim status, treatment authorizations, medical management, and adjuster communications.
Provides the Director of Risk Management with regular claim status summaries, emerging exposure flags, and documentation for reserve reviews and carrier meetings.
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.
Maintains clear records of leave periods, return-to-work dates, and accommodation status.
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 to the Director and Safety team.