Senior Workers' Compensation Claims Leader

Davies Group; San Diego, Northern (CA, KY); Hybrid; USD 100,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

401(k) plan

Paid time off

Paid holidays

Life insurance

Disability coverage

Job summary

Davies North America, a division of Davies Group, is seeking a Workers' Compensation Claims Manager in San Diego, CA. You'll lead a team of adjusters handling medical-only, indemnity, and litigated claims, providing leadership, technical guidance, and quality oversight to meet client expectations and regulatory requirements.

Your experience includes 5-7 years in workers' compensation claims, 2-3 years in supervision, and knowledge of multi-jurisdictional statutes, subrogation, reserving, and EDI

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 with 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 Guidewire, RiskMaster, or similar systems.

Responsibilities

• Supervise, coach, and mentor a team of Workers' Compensation Adjusters handling medical-only, indemnity, and litigated claims.
• Review 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.

Skills

Team leadership

WC claims handling

Multi-jurisdictional WC

Subrogation knowledge

Reserving practices

EDI reporting

File audits

Adjuster license

Communication skills

Tools

Guidewire

RiskMaster

Microsoft Office

Job description

Davies North America, a division of Davies Group, is seeking a Workers' Compensation Claims Manager in San Diego, CA. You'll lead a team of adjusters handling medical-only, indemnity, and litigated claims, providing leadership, technical guidance, and quality oversight to meet client expectations and regulatory requirements.

Your experience includes 5-7 years in workers' compensation claims, 2-3 years in supervision, and knowledge of multi-jurisdictional statutes, subrogation, reserving, and EDI