Lead Workers' Compensation Claims Manager

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

Benefits offered by this job

Medical, dental, and vision plans

401(k) with employer matching

Paid time off

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 in San Diego. The role emphasizes leadership, technical guidance, and compliance with client expectations and workers’ compensation regulations.

The ideal candidate will drive staff development, monitor claim quality, manage escalated files, and foster a high-performing team environment, balancing operational priorities with client

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.
• Strong analytical, organizational, and decision-making abilities.
• Excellent written and verbal communication skills.
• Active adjuster license preferred.
• Experience with claims platforms such as Guidewire, RiskMaster, or similar systems preferred.
• Proficiency with Microsoft Office Suite, including Outlook, Excel, and Word.

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

WC claims handling

Team leadership

Multi-jurisdictional WC

Subrogation knowledge

EDI reporting

Audit & coaching

Analytical skills

Communication skills

Active adjuster license

Guidewire

Education

Bachelor's degree

Tools

Guidewire

RiskMaster

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 in San Diego. The role emphasizes leadership, technical guidance, and compliance with client expectations and workers’ compensation regulations.

The ideal candidate will drive staff development, monitor claim quality, manage escalated files, and foster a high-performing team environment, balancing operational priorities with client