Workers’ Comp Claims Manager: TPA Oversight & Strategy

LE003 Coaction Specialty Management Company, Inc.; Morristown (NJ); Hybrid; USD 96,000 - 161,000; Full time

Job summary

Coaction Specialty Insurance Group seeks a Manager of Workers' Compensation Claims to oversee two TPAs and ensure effective claims handling, timely reporting, and compliance with SLAs. The role emphasizes collaboration with underwriting, audit, legal, and senior management in a dynamic environment.

Candidates should have 5+ years of WC claims experience across multiple jurisdictions, strong analytical and leadership skills, and excellent communication.

Qualifications

• 5+ years of experience in Workers' Compensation claims handling.
• 2+ years of claims management experience, preferably with TPA oversight.
• Experience with WC claims in California, Florida, and New York.
• Bachelor’s degree in a related field.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Willingness to travel for mediations, settlement conferences, and trials.

Responsibilities

• Oversee TPAs to ensure adherence to claims handling protocols and SLAs.
• Guide TPAs in complex investigations, coverage assessments, and resolutions.
• Conduct audits of TPA performance and ensure licensed claim handlers.
• Collaborate with underwriting, internal audit, legal, reinsurance, and senior management.
• Prepare for and attend claim reviews; present to account/program representatives.
• Travel for mediations, settlement conferences, and trials as needed.

Skills

Workers' compensation

TPA oversight

Data analysis

Communication

Microsoft Office

Travel readiness

Education

Bachelor’s degree

Tools

Claims management software

Job description

Coaction Specialty Insurance Group seeks a Manager of Workers' Compensation Claims to oversee two TPAs and ensure effective claims handling, timely reporting, and compliance with SLAs. The role emphasizes collaboration with underwriting, audit, legal, and senior management in a dynamic environment.

Candidates should have 5+ years of WC claims experience across multiple jurisdictions, strong analytical and leadership skills, and excellent communication.