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

Department: Claims Administration & Adjusting

Compensation: $100,000 - $120,000 / year

Department: Claims Administration & Adjusting

Location: San Diego, CA

Compensation: $100,000 - $120,000 / year

Description

Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

Davies North America is seeking an experienced Workers' Compensation Claims Manager to lead a team of workers' compensation adjusters handling medical-only, indemnity, and litigated claims. This position is responsible for providing leadership, technical guidance, quality oversight, and coaching while ensuring compliance with client expectations, company standards, and applicable workers' compensation regulations.

The ideal candidate will bring strong technical workers' compensation expertise, multi-jurisdictional claims knowledge, and prior leadership experience. This individual will play a key role in developing adjusters, monitoring claim quality, managing escalated files, and fostering a high-performing team environment.

The role requires excellent communication, leadership, organizational, and decision-making skills, along with the ability to balance operational priorities, client service expectations, and claim outcomes.

Key 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, knowledge & expertise

• 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.

Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
• Paid holidays
• Life insurance and short‑term and long‑term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:

The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Essential Functions

• Maintain regular and dependable attendance.
• Be available and able to perform job responsibilities during established work hours.

Background Check & Fair Chance Compliance

Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements.

Massachusetts Notice

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

AI Policy

At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment.