Workers Compensation Claims Director

Questpro Consultants LLC; United States; Remote; USD 110,000 - 170,000; Full time

Benefits offered by this job

Remote flexibility

Medical, dental, and vision benefits

401(k) match

Company pension

Annual bonus

Generous PTO and holidays

Tuition reimbursement

Professional development support

Job summary

Questpro Consultants LLC is seeking a Regional Workers' Compensation Claims Director to lead a regional team delivering fair, timely, and customer-focused claim outcomes. This remote role supports profitability and regulatory compliance while partnering with underwriting, risk, and agents.

You will oversee complex claims, manage reserves, and guide a team of adjusters and counsel, with a focus on leadership development and innovation in claims operations.

Qualifications

• Bachelor's degree or equivalent in a relevant field.
• Ten years of workers' compensation claims handling experience in progressively responsible roles.
• Prior management experience; insurance designations are a plus (AIC, CIC, AIM, CPCU).

Responsibilities

• Lead and develop a regional Workers' Compensation claims team, ensuring timely, accurate, and customer-focused claim resolution.
• Provide guidance on coverage, compensability, reserving, loss exposure, and claim resolution strategies for complex and high-exposure claims.
• Monitor reserve adequacy and claim outcomes, ensuring compliance with reserving guidelines, best practices, subrogation, and recovery opportunities.
• Conduct claim file audits, approve claims within authority, and address customer or regulatory complaints.
• Oversee litigated claims, evaluating counsel performance, litigation strategy, settlement opportunities, and compliance with litigation guidelines.
• Manage relationships and performance of independent adjusters, legal counsel, and vendor partners.
• Recruit, coach, develop, and evaluate team members, including performance management and succession planning.
• Foster a collaborative, innovative, and inclusive culture across Claims and business partners.

Skills

Leadership

Analytical ability

Regulatory knowledge

Communication skills

Claims systems

Licensing

Travel willingness

Education

Bachelor's degree or equivalent

Job description

Our client, a growing national insurance carrier, is looking for a Regional Workers' Compensation Claims Director to join their team. This organization is all about working together to make an impact, offering the opportunity to grow, contribute, and gain experience that matters. They strive to be caring leaders, close partners, and responsive experts, always supporting each other to do their best work.

This position is eligible to work from home anywhere in the US.

As the Regional Workers' Compensation Claims Director, you'll lead a team responsible for delivering fair, timely, and customer-focused claim outcomes. You'll oversee complex claims, drive reserving and operational excellence, develop talent, and partner with key stakeholders to support profitability, compliance, and exceptional service. This role offers the opportunity to influence business results while making a meaningful impact on customers, agents, and employees.

Why You'll Love This Opportunity

• Remote flexibility with occasional travel for leadership and team engagement
• Comprehensive benefits including medical, dental, and vision, plus company-paid short and long-term disability
• Strong financial security: 401(k) match up to 4% plus a fully funded company pension
• Annual bonus opportunity tied to company performance
• Generous PTO starting on day one, plus paid holidays and volunteer time off
• Tuition reimbursement and professional development support

Essential Functions

• Lead and develop a regional Workers' Compensation claims team, ensuring timely, accurate, and customer-focused claim resolution.
• Provide guidance on coverage, compensability, reserving, loss exposure, and claim resolution strategies for complex and high-exposure claims.
• Monitor reserve adequacy and claim outcomes, ensuring compliance with reserving guidelines, best practices, subrogation, and recovery opportunities.
• Conduct claim file audits, approve claims within authority, and address customer or regulatory complaints.
• Oversee litigated claims, evaluating counsel performance, litigation strategy, settlement opportunities, and compliance with litigation guidelines.
• Manage relationships and performance of independent adjusters, legal counsel, and vendor partners.
• Recruit, coach, develop, and evaluate team members, including performance management and succession planning.
• Foster a collaborative, innovative, and inclusive culture across Claims and business partners.
• Partner with Underwriting, Risk Improvement, Risk Services, Marketing, agents, and insureds to communicate claim activity, trends, and significant developments.
• Manage departmental budgets and expenses, including ALAE, ULAE, staffing, and travel, while supporting profitability goals.
• Ensure compliance with state and federal regulations, licensing requirements, insurance department inquiries, and market conduct examinations.
• Prepare operational and claims performance reports, participate in strategic initiatives, and contribute to claims operations planning and industry trend analysis.

Education & Experience

• Bachelor's degree or equivalent relevant experience
• Ten years of experience with workers' compensation claims handling in progressively responsible roles
• Prior management experience
• Insurance designations such as AIC, CIC, AIM and CPCU preferred

Knowledge, Skills & Abilities

• Ability to obtain applicable state licenses
• Superior knowledge of the claim functions
• Excellent analytical ability and knowledge of legal liability and coverage
• Excellent leadership qualities with ability to motivate staff in the handling and disposition of claims
• Excellent knowledge of insurance contracts, and legal aspects of court procedures affecting legal liability for workers' compensation line of insurance
• Ability to adhere to high standards of professional conduct while providing the delivery of superior claims service
• Strong knowledge of computers and claims systems
• Superior organizational and written and verbal communication skills
• Superior investigative and problem-solving abilities
• Occasional travel; a valid driver's license with an acceptable motor vehicle report per company standards is required if driving