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Claims Assistant Manager – Workers' Compensation

Work from home Full-time role Hiring

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 Apply To this Job

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