Lead and manage a team of workers' compensation claims specialists in a fully remote environment, ensuring accurate and timely handling of litigated and high-complexity claims across various jurisdictions. This role combines hands-on claims oversight with leadership responsibilities, guiding team members through investigation, evaluation, and resolution processes while maintaining strict adherence to regulatory and procedural standards.
Key Responsibilities
- Oversee the end-to-end management of complex claims, conducting regular file reviews to ensure proper coverage determination, medical oversight, reserve accuracy, and legal coordination
- Step in to adjust claims during peak volumes or staffing gaps, applying deep knowledge of workers' compensation laws and claims best practices
- Coach and develop team members through regular feedback, performance evaluations, goal setting, and career planning discussions
- Ensure compliance with communication protocols for clients, claimants, and fronting carriers, particularly on reportable and high-exposure cases
- Lead litigation strategy discussions, ensuring timely responses and strong defense of insured and carrier interests
- Manage hiring, onboarding, timesheet approval, and compensation recommendations for direct reports
- Facilitate team meetings, claim roundtables, and training sessions to maintain process consistency and service quality
- Use performance metrics to identify improvement areas and implement operational changes
- Mediate coverage disputes and coordinate large loss reporting between insureds and carriers
- Stay current with evolving state-specific insurance regulations and licensing requirements
Qualifications
Candidates must have a high school diploma and an active workers' compensation license in at least one state, or the ability to obtain one within three months. A minimum of five years of experience adjusting property and casualty claims—including litigated files—is required. Strong understanding of workers' compensation coverage application, claims lifecycle management, and multi-state regulatory environments is essential. Proficiency in claims systems and processes is expected.
Preference will be given to applicants with a college degree, professional designations such as AIC or CPCU, and prior experience in agency, carrier, or loss control roles. Supervisory experience is highly valued.
Work Environment & Benefits
This is a fully remote position with flexibility built into daily operations. Employees benefit from comprehensive support for professional growth, including tuition reimbursement and continuing education funding. The organization contributes directly to employee 401k accounts annually through a profit-sharing model and offers discretionary bonuses.
Additional benefits include generous paid time off, paid parental leave, volunteer time off with charitable matching, and dedicated diversity, equity, and inclusion initiatives—including paid time to observe Diversity Day. The culture emphasizes trust, clear communication, and meaningful client relationships, supported by structured development paths and merit-based advancement.
