Workers' Compensation Claims Manager

Davies • San Diego, CA

22h

About The Position

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.

Requirements

• 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.
• Proficiency with Microsoft Office Suite, including Outlook, Excel, and Word.

Nice To Haves

• Active adjuster license preferred.
• Experience with claims platforms such as Guidewire, RiskMaster, or similar systems preferred.

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.

Benefits

• 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
• Paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed