Senior WC Claims Leader — Hybrid

certexamdb.com; Tampa (FL); Hybrid; USD 122,000 - 158,000; Full time

Benefits offered by this job

Great benefits

Wellness program offerings

Company retreats

Job summary

Justworks in Tampa, FL is seeking a Senior Manager, Workers' Compensation Claims to lead a small team while handling a complex caseload. The role focuses on coverage decisions, reserves, and timely resolutions within a PEO environment, with cross-functional collaboration across Customer Success, Technology, and Finance.

The ideal candidate has 7+ years in WC claims, strong leadership, and experience with RMIS systems, Return to Work programs, and vendor management.

Qualifications

• 7+ years of experience in a Third Party Claims Administration(TPA) or PEO environment in claims.
• Mentoring, training or informal leadership of peers or junior claims associates.
• Working knowledge of WC regulations across multiple states.
• Solid reserving skills and understanding of indemnity, medical and expense components.
• Strong organizational and communication skills; able to interact with customers and partners.
• Proficiency with claims management systems and RMIS platforms.
• Experience supporting Return to Work programs and managed care coordination.
• Experience working cross-functionally with internal/external teams.
• Vendor management experience.

Responsibilities

• Supervise and support a small claims team with daily direction and performance coaching.
• Manage own active caseload of complex, litigated, and high-severity claims from First Notice of Loss through closure.
• Review coverage decisions, reserves and settlement recommendations for accuracy and consistency.
• Serve as primary escalation point for difficult claims or coverage disputes.
• Conduct file audits and quality reviews, delivering feedback to improve performance.
• Coordinate with TPAs, carriers, defense counsel, medical providers, and nurse case managers to drive timely resolutions.
• Onboard and train new staff, ensuring familiarity with PEO workflows and state compliance.
• Maintain knowledge of WC statutes and filing requirements across jurisdictions.
• Assist Claims Director with reporting and loss trend analysis.

Skills

TPA/PEO claims

Mentoring/leadership

WC regulations (multi-state)

Reserving & financials

Organizational skills

Communication skills

RMIS/claims systems

Return to Work programs

Vendor management

Cross-functional collaboration

Tools

Claims management systems

RMIS platforms

Job description

Justworks in Tampa, FL is seeking a Senior Manager, Workers' Compensation Claims to lead a small team while handling a complex caseload. The role focuses on coverage decisions, reserves, and timely resolutions within a PEO environment, with cross-functional collaboration across Customer Success, Technology, and Finance.

The ideal candidate has 7+ years in WC claims, strong leadership, and experience with RMIS systems, Return to Work programs, and vendor management.