Analyst - Claims

Protect the assets of the organization relative to legal liabilities incurred as a result of damages sustained by Wendy's employees and third parties who are involved in accidents related to our premises, property, vehicles, and/or products. Administer claims under various line of liability insurance (including general liability, property, product liability, and state workers' compensation, working collaboratively with claims TPA for workers' compensation claims and other claims as necessary and appropriate. Effective management of assigned claims with a goal of mitigating the Company's risks on individuals claims and in support of the overall claims portfolio through timely and effective claim management strategies and consistent application of process and experience.

Responsibilities

Conduct early case assessment and continuously evaluate several key factors, including available facts and evidence related to potential liability on claim, applicable statutory and regulatory scheme, and other considerations that could impact ultimate risk for purposes of determining eligibility for benefits and/or compensation under applicable insurance program, timely and accurately setting and adjusting legal reserves up to applicable limit and providing timely and accurate claim information for effective review by escalation approvers as needed, identifying and executing effective negotiation and settlement strategy, and, if applicable, aligning effective litigation strategy. This may include effectively partnering with other stakeholders, such as TPA, supervisors and/or other leadership in department, and outside counsel, as applicable, to provide strategic direction/business objectives, obtain input and/or advice to inform assessment and strategy, and/or ensure appropriate alignment and visibility.

Effectively develop rapport with injured individual or damaged party to gather information, provide guidance and facilitation of claims process, and assess claim severity and risk. Manage claims portfolio with a goal of cost-effective and timely resolution of claims where possible, effectively leveraging analyst experience, Company claims experience, and advice and input from internal and external resources as appropriate.

Continuously evaluate opportunities for education, training, and/or process improvements related to claims prevention and/or claims management, with a goal of helping to unique insights that may help inform process improvements or changes for claims team or other departments (ex. safety, ops, security, HR). Provide appropriate visibility to claim supervisors to help inform on trends and new high risk situations. Develop and maintain resources, job aides, and other materials to support education and training.

Manage and direct vendors providing various support services and representation of the Company in relation to the claims process. Promote effective utilization of vendors (ex. Kingstree) and collect information and insights related to help support effective partnership with those vendors.

Consistently document claims in established claims management system to ensure complete and accurate records of all claims. Maintain accurate diaries for all active claims, documenting actions taken and follow up needed.

Other duties as may be assigned to support claims group, Global Litigation, Employment & Claims Team, and/or Legal Department.

Liability Assessment - assessment of applicable statutory requirements, relevant facts and evidence to inform decision to accept or deny claim, evaluate if alleged injuries are reasonable related to the incident in question, evaluate potential alternative causes and/or responsible parties, and make appropriate reservation of rights.

Financial reserves - determining most probable outcome of claim and establishing reasonable financial estimates in reserve based on liability assessment and other considerations (ex. Geography, diagnoses and other medical information). Authority to approve or recommend reserve amounts will be subject to applicable approval matrix.

Settlement - negotiate settlements consistent with approved settlement forms and process in exchange for a full release of claims. Authority to approve or recommend settlement amounts will be subject to applicable approval matrix.

Conduct investigations in a risk-based manner, obtaining information regarding facts, defenses and claimed injuries for claims as appropriate to support defense of claims with low to medium complexity with minor supervision. Assist with investigations of complex claims as assigned by supervisor. Partner with TPA, if applicable, to understand applicable statutory and regulatory scheme as part of early case assessment to ensure necessary information is gathered and optimal process is followed. Effectively leverage restaurant management, HR, security, safety, and other Company resources as needed to best support cost-effective claims management.

Education: Bachelors Degree

2 years GL or W/C claim experience

Competencies

• Strong organizational skills and ability to prioritize and multi-task
• Strong interpersonal communication skills, management and influence skills, including ability to effectively listen and communicate, quickly build rapport, and deescalate situations
• Precise analytical skills
• Excellent verbal and written communication.
• Ability to perform moderately complex mathematical and financial calculations in an accurate manner based on a variety of independent variables.
• Strong collaborative partnership and cross-functional leadership skills
• Detail oriented with strong technical, analytical and problem-solving skills
  
  

Moderate proficiency with the use of Microsoft Office and prior experience utilizing a Risk Management Information System application

Education: High School Diploma/GED

Travel: 10%

Pay Range: $52,000 - $88,000 Annually