Workers Compensation Claims Manager

Gallagher•Lake Mary, FL

1d•Onsite

About The Position

EGIS Insurance & Risk Advisors, now a part of Gallagher, is seeking a Workers' Compensation Claims Manager to join our Program Administration team in Lake Mary, Florida. As the Program Administrator for the Florida Insurance Alliance (FIA), the fastest-growing governmental insurance trust in Florida, EGIS provides insurance and risk management services to governmental entities and public charter schools across the state. This is an exciting opportunity to play a key role in overseeing workers' compensation claims operations while helping drive service excellence and positive outcomes for FIA members. Reporting to the Executive Vice President, the Workers' Compensation Claims Manager will oversee FIA's Workers' Compensation claims operations and ensure Third-Party Administrators (TPAs) manage claims in accordance with FIA's claims philosophy, service standards, and policy guidelines. This highly visible role serves as a liaison between FIA, TPAs, members, legal counsel, reinsurers, and other stakeholders. The ideal candidate will bring strong workers' compensation claims expertise, a strategic mindset, and a commitment to delivering exceptional service while supporting operational improvements and claims best practices.

Requirements

High school diploma and 10 years related claim experience required.
At least 3 of supervisor experience required.
Appropriately licensed and/or certified in all states in which claims are being handled.
Knowledge of all team member related functions.
Exceptional analytical and problem-solving skills.
Ensures flawless and consistent execution of client service instructions and performance guarantees.
Ability to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization.

Nice To Haves

Bachelor’s degree preferred.

Responsibilities

Oversee FIA's Workers' Compensation claims operations.
Monitor TPA performance and ensure compliance with claims handling standards and best practices.
Coordinate claims activities among FIA members, TPAs, legal counsel, reinsurers, and other stakeholders.
Attend mediations, hearings, and other proceedings on behalf of FIA as needed.
Facilitate timely reporting and communication of claims information to TPAs and reinsurers.
Participate in TPA audits and support ongoing quality assurance initiatives.
Analyze policy coverage and determine claim applicability under coverage provisions.
Assign defense counsel and oversee implementation of appropriate claim strategies.
Identify and report claims that meet reinsurer reporting requirements.
Drive claims-related process improvements and operational initiatives.
Establish accountability measures to promote service excellence and customer satisfaction.
Support brokers and agency partners by responding to coverage questions and providing claim updates.
Develop strong working relationships with members, management companies, brokers, vendors, reinsurers, and outside counsel.
Collaborate with Underwriting, Loss Control, and Program Administration teams on strategic initiatives and member service enhancements.
Participate in training, webinars, and professional development opportunities.
Perform other duties as assigned.