Workers' Compensation Claims Manager

Location: West Dallas, TX
Employment Type: Full-Time
Position Level: Management

Position Overview

We are recruiting for an experienced Workers' Compensation Claims Manager to oversee the daily operations of a workers' compensation claims unit for an established organization within the claims administration industry.

This position is responsible for leading Claims Supervisors, Claims Examiners, and Claims Assistants, ensuring high-quality claims handling, regulatory compliance, operational efficiency, and strong client service.

The ideal candidate will bring a strong background in workers' compensation claims administration, demonstrated leadership capabilities, and the ability to manage claims operations, develop staff, and maintain effective client relationships.

Key Responsibilities

• Manage and oversee the daily operations of a workers' compensation claims unit, including Claims Supervisors, Claims Examiners, and Claims Assistants.

• Provide leadership, coaching, performance evaluations, and ongoing professional development for assigned staff.

• Oversee claims-handling activities, including initial and periodic reviews, delays, denials, and other time-sensitive claim decisions.

• Review and approve reserve changes, awards, and payments within established authority levels.

• Conduct claim-file reviews to evaluate claims quality, documentation, reserve adequacy, and compliance with applicable laws and client requirements.

• Monitor claims inventories, workloads, and staffing levels to maintain operational efficiency and service standards.

• Coordinate staff training on regulatory changes, claims-handling procedures, and industry best practices.

• Oversee financial controls, including payment approvals, check runs, and expense management.

• Address escalated claimant, client, and vendor concerns and facilitate timely resolution.

• Monitor vendor performance and service quality.

• Ensure compliance with client-specific claims-handling instructions and service expectations.

• Coordinate claims-handling coverage during staffing vacancies or employee absences.

• Prepare and review monthly client reports for accuracy, completeness, and timely delivery.

• Facilitate internal and external claims audits and oversee corrective actions when necessary.

• Participate in client file reviews and address claims-handling questions and recommendations.

• Support client account management activities and collaborate with internal teams on service-related matters and requests for proposals.

• Monitor operational expenses and approve invoices within established authority levels.

Required Qualifications

• Active Texas Adjuster License required.

• 5–10 years of related workers' compensation claims experience, or an equivalent combination of education and experience.

• Demonstrated experience supervising, coaching, and developing workers' compensation claims professionals.

• Strong technical knowledge of workers' compensation claims handling, applicable statutory and regulatory requirements, and medical terminology.

• Experience overseeing claims operations, reviewing complex claims, and evaluating reserve adequacy and claims quality.

• Ability to manage claims diary systems, prioritize competing responsibilities, and meet established deadlines.

• Strong analytical, problem-solving, and decision-making skills.

• Effective leadership and interpersonal skills, with the ability to manage employees across varying experience levels.

• Excellent written and verbal communication skills, including the ability to communicate technical claims information to clients, management, and staff.

• Strong client service skills and the ability to professionally resolve escalated concerns.

• Ability to monitor workloads, coordinate staffing needs, and maintain consistent claims quality and service standards.

• Proficiency in Microsoft Word and Excel.

• High school diploma or GED required.

Preferred Qualifications

• Bachelor's degree in a related field.