Lead Workers' Compensation Claims Manager

Davies; San Diego (CA); On-site; USD 100,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) matching

Paid time off

Paid holidays

Life insurance

Job summary

Davies North America is seeking an experienced Workers' Compensation Claims Manager to lead a team of adjusters handling medical-only, indemnity, and litigated claims. The role requires leadership, technical guidance, and compliance with regulations while developing staff and ensuring high-quality outcomes.

The ideal candidate will have 5-7 years in WC claims, 2-3 years of supervisory experience, and strong knowledge of multi-jurisdictional statutes, subrogation, reserving, and reporting.

Qualifications

• 5-7 years of Workers' Compensation claims handling experience.
• 2-3 years of supervisory, team lead, or claims leadership experience.
• Strong understanding of multi-jurisdictional Workers' Compensation statutes and claim handling procedures.
• Experience managing or overseeing medical-only, indemnity, and litigated claims.
• Knowledge of subrogation, excess reporting, reserving practices, and EDI reporting requirements.
• Experience conducting file audits, performance reviews, and coaching adjusters.

Responsibilities

• Supervise, coach, and mentor a team of Workers' Compensation Adjusters handling medical-only, indemnity, and litigated claims.
• Conduct regular file reviews, audits, and performance evaluations to ensure compliance with company standards and client requirements.
• Review and approve reserves, settlement recommendations, claim strategies, and authority requests within established guidelines.
• Provide technical guidance on compensability, reserving, litigation management, return-to-work coordination, subrogation, and excess reporting.
• Monitor adjuster productivity, diary management, claim quality, customer service metrics, and file handling practices.
• Support onboarding, training, and professional development of new and existing team members.
• Ensure compliance with state-specific workers' compensation laws and client-specific handling instructions.
• Manage escalated and complex claims as needed.
• Collaborate with defense counsel, Nurse Case Managers, medical providers, vocational professionals, and client stakeholders.
• Participate in client meetings, stewardship reviews, and claim strategy discussions.
• Identify trends, process improvement opportunities, and training needs across the team.
• Promote a positive, collaborative, and performance-driven work environment.

Skills

Team leadership

Claims handling

Workers' comp knowledge

Analytical skills

Communication skills

Licensed adjuster

Multi-jurisdictional WC

Guidewire

RiskMaster

Microsoft Office

Tools

Guidewire

RiskMaster

Microsoft Office

Job description

Davies North America is seeking an experienced Workers' Compensation Claims Manager to lead a team of adjusters handling medical-only, indemnity, and litigated claims. The role requires leadership, technical guidance, and compliance with regulations while developing staff and ensuring high-quality outcomes.

The ideal candidate will have 5-7 years in WC claims, 2-3 years of supervisory experience, and strong knowledge of multi-jurisdictional statutes, subrogation, reserving, and reporting.