Director of Workers' Compensation Claims Operations

The salary range for this position is $108,812.00 - $174,099.00 annually, plus bonuses and benefits. Pay Type: Salary

The salary range reflects the full potential compensation for the position. Specific pay is determined by your location, education, experience, and other relevant factors, and will be discussed further during the hiring process. This role will oversee the Workers' Compensation claims team focused on Large Atlantic and New England regions and will report to the Regional Vice President of Commercial Lines. While candidates based in the Charlotte area are highly preferred, we welcome applicants from designated payroll states.

Are you a Referral?

If you know an existing Encova Insurance associate and wish to apply as a referral, please have them submit your information before you apply. Once submitted, you'll receive a direct URL link to this job posting.

Please check the unique residence requirements in this job posting.

Encova can only hire individuals residing and working within specific U.S. states due to payroll statutes. Our current operations include: Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin.

JOB OBJECTIVE:

The Director of Workers' Compensation Claims Operations will oversee the daily performance of the claims adjusting team and health care professionals. This includes providing leadership that ensures top-notch, cost-effective service while adhering to best claims practices and loss control standards.

ESSENTIAL FUNCTIONS:

Supervise the claims management activities of the team.

Ensure effective onboarding for new policyholders.

Evaluate and assign claims to adjusters as needed.

Provide guidance for navigating complex injury cases.

Establish and adjust reserve values throughout the life of claims.

Consult with medical, legal, and vocational experts to facilitate beneficial claim outcomes.

Analyze rehabilitation and legal reports, advising staff accordingly.

Support claims staff in investigating and settling claims effectively.

Assist with subrogation recovery efforts.

Participate in claim discussions, offering guidance when necessary.

Represent the organization on special projects and at local meetings.

Train and mentor new team members on procedures.

Work collaboratively to manage claim costs and promote timely return-to-work outcomes.

Conduct quality assurance file reviews for claims staff.

Facilitate meetings with policyholders and collaborate with the Business Director.

Work with Claims Operations on policy and best practices development.

Identify and analyze claims-related reports to guide future profitability.

Engage with SLC Specialists as applicable to assess and improve loss prevention efforts.

OTHER FUNCTIONS:

Perform additional duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

Bachelor's degree preferred.

A minimum of five years' experience in insurance, with work history with private carriers or third-party administrators.

Experience in managing multiple state insurance claims is favorable.

Knowledge in claims adjusting, case management, or safety and loss control preferred.

Proven leadership and mentoring abilities.

Strong communication skills.

Advanced understanding of workers' compensation statutes and practices.

Ability to analyze and reconcile complex issues effectively.

Proficient in a paperless work environment.

Encova Insurance prioritizes diverse ideas and is committed to providing an environment where our associates can excel. We encourage you to apply and join a team that values your contributions. This position may require accommodations for disabilities as per the Americans with Disabilities Act.

What can you expect?

Encova Insurance offers a competitive salary, bonus potential, and comprehensive benefits including a 401(k) plan, wellness programs, flexible schedules, and more. We also support community engagement through our initiatives.

Encova Insurance is an EOE/E-Verify employer.

Permanent