Claims Assistant Manager – Workers' Compensation
Job Description:
• Supervises assigned claims team and reviews claim files to ensure completeness, accuracy, and appropriate fact development.
• Assigns claims to handlers based on complexity, skills, and experience, and provides strategic guidance on coverage, compensability, liability, claim valuation, negotiation, and resolution.
• Reviews and approves reservation of rights and denial letters; assigns or assists with selection of defense counsel and monitors litigated matters.
• Ensures timely and appropriate reserving in compliance with client contracts, company guidelines, authority levels, and regulatory requirements.
• Ensures claims are handled in accordance with best practices, good‑faith standards, client special handling instructions, and claims philosophy, including proper file documentation.
• Oversees team workload, productivity, and performance; monitors dashboards, scorecards, and key performance metrics.
• Conducts file audits, identifies improvement opportunities, and implements action plans.
• Establishes performance goals, conducts performance reviews, provides coaching, and addresses disciplinary issues as needed.
• Interviews, hires, and manages compensation recommendations; develops team expertise and supports succession planning through talent identification and development plans.
• Builds and maintains strong relationships with clients, agents, brokers, and internal stakeholders through proactive communication and client visits.
Requirements:
• Bachelor’s degree, preferably in insurance, or equivalent relevant experience
• Eight years of claims adjusting experience, including experience with large and complex claims
• Strong understanding of workers' compensation preferred
• Attainment of all applicable state licenses within six months of hire
• Prior leadership or supervisory experience preferred
• Prior experience with a third party administrator (TPA) preferred
• Insurance industry coursework (e.g. INS, AIC, CPCU) preferred
Benefits:
• Outstanding benefits with life, medical, dental, vision and prescription drug coverage
• Competitive paid time off plan and a full day of volunteer time off annually
• Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
• Professional development and growth opportunities, including tuition reimbursement
• Wellness initiatives to improve team member well-being and reduce health insurance costs
• Flexibility to dress for your day and opportunities for alternative work arrangements
• Supervises assigned claims team and reviews claim files to ensure completeness, accuracy, and appropriate fact development.
• Assigns claims to handlers based on complexity, skills, and experience, and provides strategic guidance on coverage, compensability, liability, claim valuation, negotiation, and resolution.
• Reviews and approves reservation of rights and denial letters; assigns or assists with selection of defense counsel and monitors litigated matters.
• Ensures timely and appropriate reserving in compliance with client contracts, company guidelines, authority levels, and regulatory requirements.
• Ensures claims are handled in accordance with best practices, good‑faith standards, client special handling instructions, and claims philosophy, including proper file documentation.
• Oversees team workload, productivity, and performance; monitors dashboards, scorecards, and key performance metrics.
• Conducts file audits, identifies improvement opportunities, and implements action plans.
• Establishes performance goals, conducts performance reviews, provides coaching, and addresses disciplinary issues as needed.
• Interviews, hires, and manages compensation recommendations; develops team expertise and supports succession planning through talent identification and development plans.
• Builds and maintains strong relationships with clients, agents, brokers, and internal stakeholders through proactive communication and client visits.
Requirements:
• Bachelor’s degree, preferably in insurance, or equivalent relevant experience
• Eight years of claims adjusting experience, including experience with large and complex claims
• Strong understanding of workers' compensation preferred
• Attainment of all applicable state licenses within six months of hire
• Prior leadership or supervisory experience preferred
• Prior experience with a third party administrator (TPA) preferred
• Insurance industry coursework (e.g. INS, AIC, CPCU) preferred
Benefits:
• Outstanding benefits with life, medical, dental, vision and prescription drug coverage
• Competitive paid time off plan and a full day of volunteer time off annually
• Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
• Professional development and growth opportunities, including tuition reimbursement
• Wellness initiatives to improve team member well-being and reduce health insurance costs
• Flexibility to dress for your day and opportunities for alternative work arrangements