Senior Claims Specialist

External Title: Senior Claims Specialist

Department: Safety

Reports To: Director of Environmental, Health, Safety & Risk

Work Environment: Hybrid / Remote (multi-state operation)

Scope: Workers’ Compensation, Auto Liability, General Liability

Role Purpose

The Senior Claims Specialist is a front-line owner of workers’ compensation, auto, and general liability claims in a fleet-intensive, service-based organization with thousands of daily drivers and technicians operating across multiple states.

This role is designed to reduce total cost of risk, shorten claim lifecycle, challenge reserves, and improve injured-employee outcomes through early intervention, tight claim control, and strong partnerships with Operations, Safety, HR, Fleet, and insurance partners.

This is not a passive claims role — it is a results-driven, metrics-owned position.

Core Responsibilities

End-to-End Claim Ownership

· Own claims from first notice of loss through closure for:

o Workers’ compensation

o Auto liability / fleet accidents

o General liability incident

· Ensure same-day reporting, accurate documentation, and regulatory compliance across all operating states.

· Serve as the primary liaison with TPAs, carriers, defense counsel, medical networks, and brokers.

· Proactively manage and challenge reserves, treatment paths, litigation strategy, and settlement recommendations.

· Drive closure velocity and reduce inactive or stale claims.

Fleet & Auto Claims Focus (Critical)

· Partner with Fleet, Safety, and Operations on driver-related claims and accident trends.

· Leverage telematics, video, and driver data to:

o Determine liability

o Challenge fault

o Support defense strategies

· Support driver coaching, corrective action, and claim-driven risk mitigation strategies.

Injury Management & Return-to-Work

· Coordinate medical care, Transitional Duty, and Return-to-Work programs to:

o Reduce lost time

o Improve employee experience

o Minimize indemnity exposure

· Actively monitor treatment plans and escalate concerns involving:

o Extended care

o Questionable diagnoses

o Attorney involvement

o Missed work restrictions

· Partner with HR to ensure compliant and compassionate employee communication.

Claims Analytics & Cost Control

· Track and trend key performance indicators including:

o Claim frequency and severity

o Average cost per claim

o Litigation rate

o Claim aging

o Reserve accuracy

· Produce executive-level reporting and dashboards to support leadership decision-making.

Safety & Risk Collaboration

· Work directly with the Safety team to:

o Identify claim-driven risk trends

o Support root cause analysis for serious incidents

o Validate corrective actions

· Provide feedback to Operations that connect claims outcomes to field behavior, training gaps, and policy effectiveness.

Field Leadership Support

· Coach General Managers, Service Leaders, and Supervisors on:

o Proper injury reporting

o Employee communication after incidents

o Claim expectations and timelines

· Act as a calm, credible resource during high-stress or high-severity events.

Required Qualifications

· 2+ years of hands-on claims management experience (workers’ compensation strongly required).

· Experience as a safety professional in warehousing, construction, or construction support environments.

· Strong understanding of OSHA reporting requirements, including OSHA 300 and 300A logs.

· Proven success managing claims in a multi-state, high-volume environment.

· Experience managing fleet-related and auto liability claims.

· Strong working knowledge of claims systems, TPAs, and carrier workflows.

· Ability to interpret and challenge medical, legal, and reserve decisions.

· Exceptional communication and relationship-management skills.

Preferred Qualifications

· Experience in HVAC, plumbing, electrical, construction, restoration, logistics, or home services.

· Familiarity with Safety Management Systems, telematics, and incident reporting platforms.

· Bachelor’s degree preferred.

· Professional designations such as AIC, ARM, CPCU, or similar.

· Data-driven mindset with strong Excel and reporting capabilities.

Success Metrics (How This Role Is Measured)

· Reduction in total cost of risk.

· Decrease in average cost per claim.

· Improved claim closure rate and reduced claim aging.

· Lower litigation rates.

· Improved injured-employee outcomes and return-to-work timelines.

· Positive carrier and broker feedback.

Why This Role Exists

This organization operates at scale. Claims must be:

· Actively managed

· Operationally connected

· Financially accountable

The Senior Claims Specialist plays a direct role in protecting employees, controlling costs, supporting operations, and driving measurable ROI across the business.

Service Experts Heating & Air Conditioning is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

The job description is not intended to be a complete list of all responsibilities, duties or skills required for the job and is subject to review and change at any time, with or without notice, in accordance with the needs of Service Experts.

Service Experts is committed to making our workplace accessible to individuals with disabilities and will provide reasonable accommodations, upon request, for individuals to participate in the application and hiring process. To request an accommodation, please email [email protected]