Director of Claims Management

Job Summary:

Seeking a strategic and results‐driven Director of Claims to lead our workers’ compensation claims department. This role is responsible for overseeing all aspects of workers’ compensation claims management, ensuring efficiency, accuracy, and compliance with legal and regulatory standards. The Director of Claims will develop and implement best practices, streamline processes, and leverage technology to enhance claims operations while maintaining a strong focus on cost control and risk mitigation. The ideal candidate will have deep industry expertise, strong leadership skills, and a commitment to fostering a high‐performing team. They will collaborate both internally and externally to optimize claims handling and drive continuous improvement.

Supervisory Responsibilities:

Leads and manages a team of WC claims adjusters, providing guidance, training, and support.

Leads and develop all WC claims personnel.

Monitors and evaluates the performance of WC claims adjusters, providing feedback and coaching as needed.

Essential Job Functions:

Lead and manage the WC claims department, including supervision of WC claims adjusters, analysts, and support staff.

Develop and implement strategies for efficient WC claims processing, including workflows, technologies, and customer service practices.

Collaborate closely with the WC claims system design team to provide insightful feedback, ensuring the system's functionality supports efficient and accurate claim adjudication.

Ensure adherence to legal, regulatory, and company‐specific standards and policies.

Review and evaluate complex WC claims, providing guidance on high‐level cases and decisions.

Oversee the preparation of WC claims reports and analysis for senior management, identifying trends, and suggesting improvements.

Ensure accurate and timely settlement of WC claims while controlling costs and mitigating risk to the company.

Develop training programs for WC claims team members to enhance their skills and ensure high‐quality service.

Establish and maintain relationships with external partners, such as third‐party vendors, legal counsel, and service providers.

Collaborate with other departments (e.g., underwriting, legal, customer service) to streamline operations and improve cross‐functional communication.

Monitor key performance indicators (KPIs) for the WC claims department and lead continuous improvement initiatives.

Stay updated on industry trends, technology advancements, and regulatory changes that could affect claims management.

Foster a positive and collaborative work culture within the department, ensuring high employee morale and retention

Required Skills/Abilities: In‐depth knowledge of WC insurance claims processes, regulations, and industry best practices.

Strong leadership skills with the ability to manage, coach, and develop teams.

Excellent problem‐solving and decision‐making abilities, especially for complex WC claims scenarios.

Exceptional communication and interpersonal skills, with the ability to collaborate across departments.

Strong analytical skills with experience in data‐driven decision‐making and reporting.

Proficiency with WC claims management software and other relevant tools.

Education and Experience:

Bachelor's degree in Business, Insurance, Risk Management, or related field (preferred).

10 years of experience in WC claims management or a related field with at least 4 years in a leadership role.

Physical Requirements:

Prolonged periods sitting at a desk while working on a computer.

Prolonged periods of standing, walking, reaching, bending may be required.

Must be able to lift 10 pounds at a time.

Additional Requirements:

Due to the nature of our business, and urgency of our clients' needs, you may be required to

participate in the Company’s on call program and work on holidays/weekends according to the

on‐call schedule.

Job Type: Full-time

Pay: $175,000.00 - $285,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• Holidays
• On call
• Weekends as needed

Experience:

• Workers compensation claims management: 5 years (Required)
• Leadership: 4 years (Required)

Ability to Commute:

• Monsey, NY 10952 (Required)

Work Location: In person

Salary : $175,000 - $285,000