Workers Compensation Claim Manager

The manager oversees a team of Claim Specialists who address claims of varying complexities within the department. This role involves tracking claim trends and regularly reporting findings to department leadership, along with action plans to mitigate any negative trends. Candidates residing in Pacific Standard Time regions are highly preferred. A deep understanding of California Workers’ Compensation statutes is essential. The manager will direct policies and procedures to ensure that claim handling aligns with the company’s best practices, as well as all relevant legal and regulatory standards.

Collaboration with the Assistant Vice President is a key aspect, focusing on the planning and establishment of regional business goals. Working alongside risk engineering, underwriting, account executives, vendor management, and legal teams, the manager will address trends that could affect claims costs and develop guidelines that support the department’s and company’s objectives. Technical support should be provided to claims specialists, drawing from industry publications, seminars, and various resources to remain current on essential updates.

Staying informed about recent legal rulings and trends by reviewing case law is also critical. Ensuring a competent claims staff is vital for the timely and equitable resolution of claims based on applicable contracts, state regulations, and company policies. Coverage issues will be identified, including a review of all coverage evaluation letters. The manager will approve recommendations for case reserves and oversee the adequacy of reserves for claims managed by the team.

Guidance in claim negotiations and extending settlement authority to Claims Specialists is essential, as is recruiting, mentoring, and retaining skilled staff. Developing and training direct reports is important to maximize their growth and success, while also addressing any performance issues to meet both departmental and individual goals.

Setting, executing, and monitoring regional office claims objectives in alignment with the company’s mission is crucial, along with a willingness to participate in special projects beyond standard duties. Engaging with current and potential customers about the company’s claims capabilities and their specific needs is also required.

Candidates should have over eight years in WC Claims supervision or management roles, with substantial experience in California jurisdiction. A bachelor's degree or its equivalent is mandatory, alongside strong verbal and written communication skills. Proficiency in the Microsoft Office suite and Lotus Notes is also necessary.