Workers' Compensation Claims Manager (Remote)
About The Position
MEM Insurance is seeking an experienced Workers' Compensation Claims Manager to lead a team of seasoned claims professionals handling higher-complexity workers’ compensation claims. This role involves a blend of hands-on technical guidance and people leadership, focusing on coaching the team through complex coverage, litigation strategy, and high-exposure claims, while fostering a culture of accountability, collaboration, and continuous improvement. The Claims Manager will report to the Claims Operations Manager, oversee day-to-day operations for a complex claims team, drive consistent, high-quality outcomes, and champion process enhancements to improve the experience for policyholders, injured workers, and internal partners. This is an opportunity for individuals energized by mentoring others, making strategic decisions, and shaping the management of complex claims.
Requirements
- 10–15 years of progressive workers’ compensation claim experience, including handling higher‑complexity claims.
- Minimum of 1 year of experience in a leadership role or in a capacity heavily involved in planning, managing and organizing resources.
- Valid driver’s license required.
Nice To Haves
- Bachelor’s Degree preferred; a combination of education and relevant experience will be considered.
- Professional designations such as SCLA, CPCU and/or AIC are beneficial.
- Claim adjusting license beneficial, but not required.
Responsibilities
- Lead, coach and develop a high-performing team of experienced workers’ compensation claims professionals managing higher complexity claims, setting clear expectations and fostering a culture of learning, ownership and results.
- Provide hands-on technical oversight for claims involving significant financial exposure, complex coverage issues, litigation and extended life cycles, guiding strategy and key claim decisions.
- Conduct regular quality assurance and POA sessions on high‑exposure and complex claims, delivering targeted feedback to strengthen technical accuracy, reserve adequacy, settlement strategies and overall claim outcomes.
- Monitor workloads and staffing levels to ensure balanced caseloads, effective workflow management and alignment with departmental objectives; recommend staffing or resource adjustments as needed.
- Review and approve reserves, settlements and payments above adjuster authority, ensuring decisions comply with company standards, statutory regulations and overall claims strategy.
- Use performance metrics and claim outcomes to evaluate team effectiveness, identify trends, and implement action plans that improve results, efficiency and consistency.
- Enhance onboarding, training and ongoing development programs so new and existing team members quickly build and deepen advanced skills such as reserve analysis, litigation management, negotiation and complex claims resolution.
- Drive continuous improvement and innovation by identifying opportunities to streamline workflows, leveraging technology and automation tools, and removing barriers that impact productivity and service.
- Promote strong cross-functional collaboration with CompLegal, Risk Services and other internal partners to ensure a unified, proactive approach to claims strategy and execution.
- Serve as a visible, trusted leader and liaison between senior leadership and the team, keeping employees informed of organizational goals, initiatives and process updates while aligning team efforts with MEM’s vision, mission and values.
Benefits
- Medical, Dental, and Vision health plans
- Fertility benefits
- Fully paid preventative care
- Adult orthodontia
- Employer-Paid Life Insurance (3x base salary)
- AD&D
- Short and Long-term Disability
- Wellness and Recognition Program with employer-paid incentives for employees and spouses
- Flexible Spending Account
- Dependent Care options
- Health Savings Account with generous employer contribution
- Generous PTO
- 11 Holidays + 4 Early Releases
- 16 Hours Volunteer Time Off
- 20 Days Paid Parental Leave
- Marriage leave
- Bereavement leave
- Jury Duty leave
- Employee Assistance Programs
- 401k Retirement Plan with employer match and profit sharing
- Adoption Assistance
- Tuition Assistance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
