Claims investigator Jobs in Winston-Salem, NC

Job Title : Claims and Benefits Administrator

Employment Type : Full-Time

Department : Human Resources

Location : Winston-Salem, NC

About the Role

We are seeking an experienced Claims and Benefits Administrator to support critical HR functions related to employee benefits administration, insurance claims processing, compliance, and reporting . This position plays a key role in managing the company’s benefits programs and overseeing all claims activities, including workers’ compensation , vehicle accidents , and general liability / property claims .

This role requires strong analytical skills, attention to detail, and the ability to coordinate with multiple internal teams, carriers, and external partners.

Key Responsibilities

Claims Management (Workers’ Compensation, Vehicle, General Liability)

Manage the workers’ compensation claims process, including required testing, data entry, reporting, and ongoing follow?up with carriers.

Review and verify completeness and accuracy of accident reports.

Analyze claims data for compliance with internal policies and regulatory standards.

Collaborate with HR and Safety leadership to identify trends and support initiatives to reduce claim frequency and severity.

Communicate with carriers regarding employee status updates, required documentation, and upcoming appointments.

Provide information to defense attorneys when needed, including employee details, settlement recommendations, and work status.

Oversee vehicle claims management, ensuring accurate reporting, coordinating damage estimates, and facilitating repairs with adjusters and body shops.

Work directly with carriers to coordinate general liability claim activities.

Benefits Administration & Compliance

Serve as the primary point of contact for all employee benefit programs, including health, dental, vision, FSAs, disability, life insurance, 401(k), and wellness benefits.

Conduct benefits education meetings and support open enrollment processes.

Maintain accurate benefit records within Benefit First and update benefits in Dayforce for payroll deduction accuracy.

Verify and process monthly premium statements via the VEBA Trust and track related metrics.

Assist in gathering data for benefit renewals for health, life, and retirement plans.

Ensure timely distribution of required benefits notices.

Administer COBRA and resolve administrative issues with carrier representatives.

HR Support & Reporting

Participate in leave management processes related to workers’ compensation.

Maintain HRIS records, conduct data analysis, and compile reports as needed.

Prepare eligibility reports for full?time and part?time employees.

Maintain and update company organizational charts, directories, and other HR reports.

Support investigations related to employee relations issues.

Ensure compliance with federal and state employment regulations.

Attend HR meetings, seminars, and support a variety of HR projects.

Travel to branch or field offices as necessary.

Required Skills & Competencies

Strong knowledge of employee benefits and applicable laws.

Experience handling workers’ compensation claims and regulatory compliance.

Basic knowledge of medical terminology preferred.

Strong analytical, investigative, and problem?solving abilities.

Excellent written and verbal communication skills.

Strong organizational and time?management abilities.

Exceptional customer service orientation and ethical judgment.

Education & Experience

Associate or Bachelor's degree required.

Minimum two years of experience in employee benefits administration.

Claims management experience preferred.

How to Apply

Please submit your resume and cover letter to Bethany Heath at bheath@theresource.com or click apply online.