Claims Assistant Manager (Workers' Compensation)

EMC Insurance Companies

Job Overview

Location

Remote in US

Job Type

Full-time

Full Job Description

📋 Description

• As a Claims Assistant Manager in Workers' Compensation at EMC Insurance Companies, you will play a pivotal role in leading a claims team to ensure accurate, timely, and compliant handling of complex workers' compensation claims, directly impacting client satisfaction and organizational integrity.
• You will supervise and develop a team of claims professionals, overseeing file reviews, workload distribution, performance management, and strategic decision-making on coverage, liability, and resolution, while maintaining alignment with company values of care, partnership, and expertise.
• EMC Insurance Companies is a mission-driven organization committed to improving lives through collaborative, ethical, and responsive insurance solutions, fostering a culture where employees grow, contribute, and are supported as valued partners in serving clients and communities.
• Your day-to-day responsibilities will include supervising assigned claims handlers, reviewing claim files for completeness and accuracy, assigning claims based on complexity and skill, and providing strategic guidance on coverage, compensability, liability, valuation, negotiation, and resolution.
• You will review and approve reservation of rights and denial letters, assist in selecting defense counsel, monitor litigated matters, and ensure timely and appropriate reserving in compliance with client contracts, company guidelines, authority levels, and regulatory requirements.
• You will oversee team workload, productivity, and performance by monitoring dashboards, scorecards, and key performance metrics, conducting file audits, identifying improvement opportunities, and implementing action plans to enhance efficiency and quality.
• You will establish performance goals, conduct performance reviews, provide coaching, address disciplinary issues, and support succession planning through talent identification, development plans, and hiring and compensation recommendations.
• You will build and maintain strong relationships with clients, agents, brokers, and internal stakeholders through proactive communication and client visits, and organize and lead client claim reviews and audits in collaboration with Client Services Management Consultants.
• You will collaborate with ECS and EMC leadership to educate agents, promote compliance with carrier guidelines and excess reporting requirements, and recommend strategic process improvements while promoting the claims brand, culture, and value proposition internally and within the industry.
• You will directly handle assigned claims in accordance with best practices and good-faith standards, ensuring proper file documentation and adherence to client special handling instructions and claims philosophy.
• You will support diversity, equity, and inclusion initiatives and foster a culture of innovation and continuous improvement within your team and across the claims organization.
• You will apply advanced investigative and problem-solving abilities, strong analytical judgment regarding liability and coverage, and superior organizational and communication skills to lead effectively in a dynamic claims environment.
• You will leverage excellent knowledge of computers and claims systems, insurance terms and coverages in commercial lines, insurance contracts, medical terminology, and legal aspects of court procedures to drive informed decision-making.
• Occasional travel including overnight may be required, necessitating a valid driver’s license with an acceptable motor vehicle report per company standards.

🎯 Requirements

• Bachelor’s degree, preferably in insurance, or equivalent relevant experience
• Eight years of claims adjusting experience, including experience with large and complex claims
• Strong understanding of workers’ compensation preferred
• Attainment of all applicable state licenses within six months of hire
• Prior leadership or supervisory experience preferred
• Prior experience with a third party administrator (TPA) preferred
• Insurance industry coursework (e.g. INS, AIC, CPCU) preferred
• Excellent understanding and application of claims techniques
• Advanced knowledge of insurance terms and coverages in commercial lines
• Excellent ability to gather and analyze a variety of data points to appropriately triage claims handling
• Advanced investigative and problem-solving abilities
• Analytical ability and good judgment regarding liability and coverage
• Strong leadership qualities with the ability to motivate staff and promote engagement
• Proven knowledge of insurance contracts, medical terminology and legal aspects of court procedures
• Excellent knowledge of computers and claims systems
• Superior organizational and written and verbal communication skills

🏖️ Benefits

• Comprehensive rewards package including health, dental, and vision insurance
• Retirement savings plans with company matching
• Paid time off and holidays
• Professional development and tuition reimbursement opportunities
• Wellness programs and employee assistance resources
• Tobacco-free workplace environment

Skills & Technologies

Remote

$100k-138k

Degree Required

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EMC Insurance Companies

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About EMC Insurance Companies

EMC Insurance Companies is a leading provider of commercial insurance, offering a comprehensive range of products and services to businesses of all sizes. With a strong focus on customer service and risk management, EMC partners with independent agents to deliver tailored solutions that meet the unique needs of each client. Their offerings include property, casualty, workers' compensation, and umbrella insurance, backed by a commitment to financial strength and stability. EMC is dedicated to helping businesses protect their assets, manage risks effectively, and achieve their growth objectives through reliable insurance coverage and expert guidance. They strive to be a trusted advisor and partner in their clients' success.

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