Full Job Description
JOB OVERVIEW:
We are seeking an experienced **Senior Workers' Compensation Claims Advocate** to manage a team while providing expert claims advocacy, strategic guidance, and proactive claims management for our clients. The ideal candidate will have extensive experience in workers' compensation claims handling, a deep understanding of jurisdictional regulations, and strong leadership skills to mentor and develop team members. This is a **hybrid role, requiring at least three days per week in the office** if possible.
LOCATION: Duluth GA, this is a hybrid position, with a minimum of three in-office days per week.
KEY RESPONSIBILITIES:
Claims Advocacy & Management
- Serve as a dedicated advocate for clients, managing complex workers' compensation claims from inception to resolution.
- Provide strategic oversight, ensuring claims are handled efficiently and cost-effectively by carriers, TPAs, and legal partners.
- Identify claim trends and develop tailored solutions to minimize client exposure and improve claim outcomes.
- Negotiate settlements, challenge claim denials, and advocate for fair claim handling.
Team Leadership & Development
- Oversee team workflows to ensure timely and efficient claims handling and client service.
- Conduct regular team meetings and training sessions to enhance technical knowledge, compliance awareness, and professional development.
- Establish and track key performance indicators (KPIs) for the team to ensure high-quality claims advocacy and adherence to best practices.
Client Support & Risk Mitigation
- Advise clients on best practices for injury management, return-to-work programs, and compliance with state and federal workers' compensation regulations.
- Conduct claim reviews, prepare detailed reports, and offer recommendations to reduce loss experience.
- Collaborate with clients' HR, risk management, and safety teams to implement proactive claim prevention strategies.
Carrier & TPA Liaison
- Work closely with insurance carriers, third-party administrators, and defense attorneys to ensure timely and effective claim resolutions.
- Advocate for clients in disputes, ensuring claim reserves are appropriate and settlements are fair.
Regulatory & Compliance Expertise
- Stay up to date on workers' compensation laws and industry changes across multiple jurisdictions.
- Ensure clients remain compliant with all reporting, safety, and claims handling requirements.
Data Analysis & Reporting
- Utilize claims data to identify trends, loss drivers, and areas for improvement.
- Prepare and present claim analytics reports to clients and senior leadership, offering strategic insights and recommendations.
Qualifications & Requirements
- **Experience:** Minimum **10 years** of workers' compensation claims management, advocacy, or risk consulting experience within an insurance brokerage, TPA, or carrier environment.
- **Technical Knowledge:** Strong understanding of **workers' compensation laws, claims handling best practices, and multi-jurisdictional compliance**.
- **Communication & Negotiation:** Excellent advocacy, negotiation, and interpersonal skills, with the ability to effectively communicate with clients, carriers, and legal representatives.
- **Analytical Skills:** Ability to analyze claims data, identify patterns, and develop strategic solutions to minimize costs and improve claim outcomes.
- **Technology Proficiency:** Experience with claims management systems, risk analytics tools, and Microsoft Office Suite (Excel, Word, PowerPoint).
- **Education & Certifications (Preferred):**
- Bachelor's degree in Risk Management, Business, or a related field.
- Industry designations such as **AIC (Associate in Claims), ARM (Associate in Risk Management), or CPCU (Chartered Property Casualty Underwriter)** are a plus.
Work Environment & Schedule
- **Hybrid role - minimum three days in-office preferred.**
- Occasional travel may be required for client meetings, claim reviews, or industry events.
COMPENSATION:
The base pay offered will be determined based on your experience, skills, training, certifications and education, while also considering internal equity and market data.
Why Join Us?
- Work in a dynamic and collaborative environment with industry leaders.
- Lead and develop a high-performing team of claims professionals.
- Competitive compensation and benefits package.
- Professional development opportunities, including continuing education and industry certifications.
