Claims Assistant Manager (Workers' Compensation)

• 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.

• Supports diversity, equity, and inclusion initiatives and fosters a culture of innovation and continuous improvement.

• Builds and maintains strong relationships with clients, agents, brokers, and internal stakeholders through proactive communication and client visits.

• Organizes and leads client claim reviews and audits in collaboration with Client Services Management Consultants.

• Collaborates with ECS and EMC leadership to educate agents, promote compliance with carrier guidelines and excess reporting requirements, and recommend strategic process improvements.

• Promotes and markets the claims brand, culture, and value proposition internally and within the industry.

• Directly handles assigned claims in accordance with claims handling best practices and good‑faith standards.

Education & Experience:

• 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

Knowledge, Skills, & Abilities:

• Excellent understanding and application of claims techniques

• Advanced knowledge of insurance terms and coverages in commercial lines

• Excellent ability to gather and analyze a variety of data points to appropriately triage claims handling

• Advanced investigative and problem-solving abilities

• Analytical ability and good judgment regarding liability and coverage

• Strong leadership qualities with the ability to motivate staff and promote engagement

• Proven knowledge of insurance contracts, medical terminology and legal aspects of court procedures

• Excellent knowledge of computers and claims systems

• Superior organizational and written and verbal communication skills

• Advanced investigative and problem-solving abilities

• Occasional travel including overnight, valid driver’s license with an acceptable motor vehicle report per company standards will be required if driving