Workers' Compensation Third Party Administrator (TPA) Claims Manager
Remote
Job Summary
Lead a team of Workers’ Compensation TPA Liaisons and oversee TPA relationships to ensure consistent oversight, adherence to service levels, and strong performance across Workers’ Compensation programs. Guide TPAs to follow policies and procedures; authorize reserve/settlement requests within authority; perform regular file reviews and audits to ensure best practices and accurate financial reporting. Build cross-functional collaboration with vendors, brokers, policyholders, and legal partners; participate in weekly client meetings and quarterly claim reviews; act as escalation point for customer-impacting issues and communicate expectations and protocols to TPAs. Drive remediation plans for underperforming TPAs based on audits and KPI assessments; report account changes or vendor concerns and contribute to additional projects as assigned, leveraging leadership to achieve service excellence and regulatory compliance.
Required Qualifications
- deep expertise in workers’ compensation claims handling
- regulatory requirements
- leadership and team development
- oversight of TPA performance and relationships
- ability to authorize reserve/settlement requests within authority
- conduct audits and regular file reviews
- build and maintain cross-functional relationships
- excellent communication for meetings and escalation handling
- data integrity and accurate financial reporting
Apply with one swipe on Sorce. We auto-fill applications and apply on your behalf — no cover letters, no 40-minute forms.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.