What You'll Do
Oversee the end-to-end management of litigated and high-complexity workers’ compensation claims across various jurisdictions, ensuring alignment with established best practices. Step in to handle claims directly during staffing gaps, maintaining consistent service quality. Lead regular file reviews every 90 days to assess coverage, medical oversight, legal strategy, reserves, and action plans.
Guide your team in resolving claims efficiently, supporting negotiations, and responding to inquiries from insureds, claimants, and carrier partners. Address complex coverage questions and coordinate communication in line with defined reporting standards. Play a central role in protecting the interests of both insureds and carriers during litigation, ensuring timely filings and strategic decision-making.
Supervise claims professionals by setting performance goals, conducting reviews, and fostering individual growth. Lead team meetings, coordinate training initiatives, and maintain standardized processes to support consistent outcomes. Use performance metrics to identify areas for improvement and implement changes that enhance workflow and accountability.
Requirements
- High school diploma or equivalent
- Active Workers’ Compensation license in applicable state, or ability to obtain within three months of hire
- Minimum of five years adjusting property and casualty claims, with direct experience in litigated matters
- Strong understanding of Workers’ Compensation or General and Auto Liability coverages and their practical application
- Proficiency in claims procedures and compliance protocols
- Ability to interpret and apply multi-state insurance regulations
- Capacity to pass required state licensing exams
- Solid foundation in claims principles, coverage analysis, and risk evaluation
- Demonstrated ability to support process improvement and adhere to compliance standards
Preferred Qualifications
- College degree
- Professional designations such as AIC or CPCU
- Background in agency, loss control, or carrier operations
- Prior experience in a supervisory or leadership role
Benefits
Access comprehensive health coverage including medical, dental, and vision plans. Take advantage of paid parental leave and supportive new parent resources. The company contributes annually to each full-time employee’s 401k through a profit-sharing model and covers costs for continuing education and tuition reimbursement.
Enjoy generous paid time off, including holidays and paid volunteer hours. The organization supports charitable engagement through employee gift matching and recognizes community involvement. Employees benefit from DE&I initiatives, including a dedicated Chief Diversity Officer, employee-led committees, and an annual paid Diversity Day. Career growth is encouraged through annual merit increases, promotion pathways, and discretionary bonus opportunities.
