Claims Account Manager

Job Summary

Seeking a highly skilled and experienced Claims Account Manager to join a team. This role is a critical part of organization, responsible for managing claims processes and ensuring exceptional service to our clients. The ideal candidate will have a strong background in claims handling, particularly in the construction sector, and possess the ability to work independently with minimal training. This position offers an exciting opportunity to potentially lead and manage the claims department.

Compensation Package

• Salary Range: $70,000 - $100,000 (commensurate with experience)
• Competitive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

• Manage claims processes for a diverse portfolio of accounts, with a focus on construction (40%) and middle-market businesses
• Advocate for clients by working directly with companies and adjusters to resolve claims efficiently and effectively
• Provide exceptional customer service and maintain strong client relationships
• Handle non-licensed administrative tasks as needed
• Utilize AMS 360 software to manage claims and related documentation
• Collaborate with other team members and leadership to ensure seamless operations within the claims department
• Potentially lead and manage the claims department, providing guidance and support to team members

Qualifications/Requirements

• Licenses/Certifications: Property & Casualty (P&C) Broker's License (required or must be obtained within 6 months)
• Experience: Minimum of 5 years in claims handling, preferably within an agency or as a claims adjuster; experience with larger accounts is a plus
• Technical Skills: Proficiency in AMS 360 software
• Knowledge: Familiarity with New York State labor laws and claims processes, particularly in the construction sector
• Soft Skills:
  • Strong personality with the ability to be firm, direct, and understanding
  • Excellent communication and negotiation skills
  • Ability to work independently with minimal supervision
  • Strong organizational and time-management skills
  • Problem-solving mindset with a client-focused approach

#LI-AS3

Overview:

Our insurance client is seeking an experienced Workers’ Compensation Claims Director to lead claims operations and provide strategic direction across the organization’s Workers’ Compensation portfolio. This individual will oversee claims performance, ensure quality and regulatory compliance, develop claims strategies, and lead a team of claims professionals in delivering exceptional outcomes for policyholders and business partners.

The ideal candidate will bring a strong technical Workers’ Compensation background, proven leadership experience, and a track record of improving claims outcomes, controlling loss costs, and developing high-performing claims teams.

Compensation & Benefits:

• $120,000 - $140,000/year based on experience
• Comprehensive benefits package including medical, dental, vision, and 401(k)
• Generous PTO and holiday schedule
• Hybrid work flexibility

Qualifications/Requirements

• Bachelor’s degree in Insurance, Risk Management, Business, or a related field preferred.
• 8+ years of Workers’ Compensation claims experience, with progressively increasing responsibility.
• 3+ years of claims management or leadership experience required.
• Strong technical knowledge of Workers’ Compensation claims, including indemnity, medical, litigation, reserving, settlement, and return-to-work strategies.
• Demonstrated experience managing complex and high-exposure Workers’ Compensation claims.
• Experience managing claims teams and developing high-performing claims professionals.
• Strong understanding of Workers’ Compensation regulations and compliance requirements across multiple jurisdictions.
• Proven ability to analyze claims data, identify trends, and develop strategies to improve loss results.

Responsibilities

• Provide strategic leadership and oversight of the Workers’ Compensation Claims Department, including indemnity and medical claims.
• Direct day-to-day claims operations and ensure claims are handled in accordance with company guidelines, regulatory requirements, and industry best practices.
• Lead, coach, mentor, and develop claims professionals while establishing performance expectations and measurable goals.
• Oversee claim investigation, compensability determinations, reserving, litigation management, settlement negotiations, and claim resolution.
• Monitor claims performance, loss trends, reserve adequacy, and key performance indicators to identify opportunities for improvement.
• Develop and implement claims strategies designed to improve outcomes, reduce claim costs, and enhance operational efficiency.
• Provide technical expertise and guidance on complex Workers’ Compensation claims, including catastrophic and litigated exposures.
• Partner closely with underwriting, actuarial, risk management, legal, finance, and other internal stakeholders.
• Oversee relationships with TPAs, defense counsel, medical providers, vendors, and other external partners.
• Ensure compliance with applicable Workers’ Compensation laws, regulations, company policies, and service standards.
• Review claims trends and analytics to identify emerging exposures and recommend appropriate action.
• Establish and maintain effective claims procedures, controls, and quality assurance standards.
• Prepare and present claims performance updates, trends, financial results, and strategic recommendations to senior leadership.
• Support budgeting, forecasting, and financial management for the Claims function.
• Stay current on Workers’ Compensation legislation, regulatory developments, litigation trends, and industry best practices.
• Drive continuous improvement initiatives and identify opportunities to enhance the customer and policyholder experience.
• Perform other duties and special projects as assigned.

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion. 

#LI-MW1

Senior Coverage & Complex Claims Manager | Major Case - Commercial / General Liability

Hybrid Schedule: 3 days in-office
Target Base Salary Range: $150K - $180K
Bonus: Up to 10% target bonus

Multiple office locations available across major U.S. markets.

A leading commercial insurance carrier is seeking a Senior Coverage & Complex Claims Manager to manage high-exposure general liability, auto liability, trucking, professional liability, umbrella, and excess claims handled by third-party administrators.

This is a coverage-intensive, highly visible role focused on major-case strategy, long-tail coverage, bad-faith exposure, civil remedy matters, TPA oversight, and severe claim outcomes. The role has no direct reports but oversees claim strategy, TPA activity, and communication with internal business partners.

Key Responsibilities

• Manage complex general liability, auto liability, trucking, professional liability, umbrella, and excess claims, typically involving $500K+ exposures and an active caseload of ~65 - 70 claims.
• Handle high-severity casualty claims involving asbestos, chemical substances, environmental exposures, construction, trucking, product liability, professional liability, long-tail coverage, and related complex risks.
• Evaluate coverage, liability, damages, reserves, litigation strategy, claim resolution options, and settlement dynamics.
• Handle major-case claims involving complex coverage, bad-faith exposure, civil remedy issues, class actions, long-tail exposure, and coverage disputes.
• Work with TPAs, claim professionals, underwriting, legal, operations, and internal stakeholders to support timely and effective claim handling.
• Provide technical coverage and claim guidance to internal teams and business partners.
• Develop claim-resolution strategies that support strong technical outcomes, customer service, and business objectives.
• Maintain strong claim diary management, including timely follow-up, documentation, action plans, reserve reviews, coverage updates, and resolution milestones.
• Travel up to approximately 10%, as needed.

Required Experience

• Juris Doctor required.
• 10+ years of experience handling complex commercial casualty claims, insurance defense, coverage litigation, bad-faith claims, or coverage counsel matters.
• Experience with high-severity claims involving $500K+ exposures, major-case handling, multi-jurisdictional issues, class actions, civil remedy matters, and complex settlement dynamics.
• Strong coverage analysis experience, including coverage disputes, long-tail exposure, unsupported insurance claims, and bad-faith risk.
• Experience with one or more of the following: trucking, construction, product liability, emergency services, medical professional liability, asbestos, environmental, chemical exposure, general liability, auto liability, umbrella, or excess claims.

Preferred Experience

• TPA oversight or management of TPA-handled claims.
• Middle-market claim experience.
• Prior in-house counsel, general counsel, coverage counsel, claim counsel, or law firm coverage litigation experience.
• Guidewire experience.

Skills and Attributes

• Ability to communicate with technical credibility across claims, coverage, legal, underwriting, leadership, and business teams.
• Maintain strong claim diary management, including timely follow-ups, documentation, reserve reviews, coverage updates, and resolution milestones.
• Deep negotiation, analytical, problem-solving, writing, and verbal communication skills.
• Able to process complex information, identify key issues, and communicate clear recommendations.
• Comfortable leading strategic claim discussions and making sound, cost-effective recommendations.
• Exceptional collaboration, influence, listening, and relationship-management skills.
• Able to work independently and in a collaborative team environment.
• Adaptable in a fast-paced claims environment.
• Strong Microsoft Excel, PowerPoint, and Word skills.
• Service-oriented approach with internal and external customers.

Ideal Background: Strong fit for candidates coming from a commercial carrier, claim counsel, coverage counsel, general counsel, insurance defense, or coverage litigation background with experience handling high-severity carrier claims.

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

#LI-JW3

Claims Director - Personal Umbrella (Bodily Injury Liability/Auto/Premises) Major Case Unit

Job Summary

Seeking a highly skilled and experienced Claims Director to lead a Personal Umbrella Liability claims team. This role focuses on managing a team of professionals handling complex claims, including auto, premises, and personal liability cases, with a strong emphasis on litigation and coverage analysis. This is a leadership position with no individual caseload, offering significant exposure to senior leadership and opportunities for career advancement.

Compensation Package

• Base Salary: $170,000 - $200,000/year (up to $200,000 in select locations)
• Bonus: 25% target bonus plan
• Profit Sharing: Up to 15% based on company performance
• Comprehensive Benefits Package: Medical, dental, vision, life insurance, disability benefits, and more
• Work-Life Balance: Paid time off, holidays, volunteer time off, parental leave, and flexible work arrangements
• Professional Development: Tuition reimbursement, training opportunities, and education bonuses

Responsibilities

• Claims Oversight: Lead and manage a team handling Personal Umbrella Liability claims, ensuring adherence to best practices and optimal outcomes.
• Coverage Analysis: Conduct in-depth investigations and draft comprehensive coverage letters for complex cases.
• Litigation Management: Collaborate with primary carriers, defense counsel, and internal legal teams to develop effective litigation strategies.
• Investigation & Evaluation: Oversee timely and thorough investigations into liability and damages, ensuring early recognition of exposures.
• Strategic Leadership: Provide guidance and mentorship to team members, fostering a collaborative and high-performing environment.
• Stakeholder Collaboration: Partner with senior leadership and other internal stakeholders to drive continuous improvement and innovation in claims handling.

Qualifications/Requirements

• Education: Bachelor’s degree required.
• Experience: Minimum of 8 years of relevant legal or technical claims experience, with a focus on large exposure third-party liability claims on a primary/excess basis.
• Litigation Expertise: Strong background in litigation strategy and management of complex claims.
• Coverage Analysis: Proven experience in investigating and drafting complex coverage letters.
• Geographic Knowledge: Familiarity with policy limit demands and case law in states such as Florida, Texas, and California.
• Leadership Skills: Demonstrated ability to lead and develop a team in a fast-paced, dynamic environment.
• Analytical Skills: Strong problem-solving abilities and a strategic mindset.
• Communication: Excellent written and verbal communication skills for effective collaboration with internal and external stakeholders.

#LI-BC1

Workers' Compensation Claims Manager

Job Summary

Seeking a highly experienced Workers' Compensation Claims Manager to join a team. This role involves managing the full lifecycle of Workers' Compensation claims, ensuring compliance with regulatory requirements, and delivering exceptional service to internal and external stakeholders. The position offers the flexibility of a hybrid work schedule (3 days in-office) or fully remote work. This is an excellent opportunity for a seasoned professional to lead a team and contribute to the growth of a well-established organization.

Compensation Package

• Salary Range: $120,000 - $170,000 per year
• Paid Time Off: 28 days of PTO to start
• Work Hours: 37.5-hour workweek with a daily two-hour flexible start and end time
• Health Benefits: Comprehensive health, dental, and vision insurance
• Life Insurance: Company-paid life insurance (2x annual earnings)
• Additional Perks:
  • Yearly performance reviews for salary increases
  • Discretionary performance incentive bonus
  • Education and training opportunities with financial assistance for insurance designations
  • Employee fitness program
  • Benefits start on the 1st of the month following your start date

Responsibilities

• Manage Workers' Compensation claims from inception to resolution, including coverage and compensability determinations, investigation, reserving, evaluation, and settlement.
• Review and evaluate claim reserves to ensure accurate reflection of potential exposure.
• Conduct thorough investigations, including obtaining statements, records, and other evidentiary materials.
• Provide clear and comprehensive documentation and reporting of claims handling activities.
• Maintain up-to-date knowledge of regulatory and jurisdictional requirements.
• Oversee and provide direction to defense counsel, independent adjusters, and other third-party vendors.
• Lead and mentor a team of claims professionals, fostering a collaborative and high-performing work environment.
• Ensure compliance with company standards and regulatory guidelines.
• Perform other duties as assigned.

Qualifications/Requirements

• Experience:
  • Minimum of 10 years handling Workers' Compensation Lost Time/Indemnity claims, including Med-Pay and subrogation.
  • At least 5 years of experience leading a team in Workers' Compensation claims.
• Industry Knowledge:
  • Experience in construction, forestry, logging, or oil and gas industries is a plus.
  • Strong understanding of coverage, reserving principles, investigation, and negotiation techniques.
• Licensing:
  • Must be licensed or hold a Self-Insurance Plan (SIP) certification in California.
  • Ability to handle claims in West Coast states (CA, OR, WA, AZ, ID, NV).
  • Ability to obtain and maintain state adjusting licenses as needed.
• Skills:
  • Excellent judgment, negotiation, and decision-making abilities.
  • Strong organizational skills with the ability to manage multiple tasks simultaneously.
  • Exceptional communication skills to interact effectively with clients, claimants, legal counsel, and other stakeholders.
• Other Requirements:
  • Service-oriented mindset with a commitment to providing prompt and effective claims resolution.
  • Willingness to travel, including potential overnight stays.

#LI-BC1