Workers' Compensation Third Party Administrator, Claims Manager

biBerk Business Insurance

Claims Manager overseeing TPA performance in Workers’ Compensation claims handling. Leading a team and ensuring compliance with policies, procedures, and service level agreements.

Posted 6/16/2026full-timeRemote • 🇺🇸 United StatesSeniorLead💰 $115,000 - $145,000 per yearWebsite

About the role

Key responsibilities & impact

Oversee assigned TPA relationships and ensure consistent execution of oversight and control measures
Lead and develop a team of Workers’ Compensation TPA Liaisons, establishing priorities to ensure tasks and performance goals are met
Authorize reserve/settlement requests within authority and prepare requests that exceed authority for internal senior leadership roundtable
Provide technical expertise and oversight through regular file reviews, audits, and authority approvals to ensure TPAs follow best practices and internal standard
Oversee team resolving TPA data feed errors to ensure accurate financial reporting
Build and maintain strong relationships with cross-functional teams, TPAs, vendors, brokers, policyholders, and legal partners
Participate in internal and external meetings, including weekly TPA client meetings and quarterly claim reviews
Serve as an escalation point for issues impacting the customer experience and communicate expectations, procedures, and protocols to TPAs
Evaluate TPA performance through audits; drive remediation plans when performance does not meet key performance metrics and service-level agreements
Report account changes or vendor concerns to ensure service level agreements are met
Performs additional projects and duties as assigned

Requirements

What you’ll need

Active Adjuster license
Bachelor’s Degree required
10+ years of experience handling multi-jurisdictional Workers’ Compensation Claims
Prior leadership experience required
Demonstrated experience working with third-party administrators
Strong governance, oversight, and risk assessment capabilities
Experience in conflict resolution and the ability to de escalate tense situations; comfortable in a role that requires negotiation
Deliver exceptional customer service to insureds, brokers, and TPAs
Advanced written and verbal communication skills, including the ability to communicate effectively with TPAs, senior leadership, legal, and compliance
Proficiency in understanding metrics that impact overall department objectives
Proficiency with Microsoft Office tools (Excel, Teams, PowerPoint, Word, Outlook)
Strong organizational skills with the ability to manage multiple priorities and initiatives concurrently
Ability to travel as needed

Benefits

Comp & perks

Medical (PPO/HDHP), vision, disability, and life insurance.
Enhanced dental plan with orthodontia coverage in addition to a standard plan.
Generous PTO plan for all benefit-time eligible employees.
Paid company holidays and 4 floating holidays.
Paid parental leave.
Employee Retirement Savings Plan/401(k) with company match and immediate vesting.
Education Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs.
Service Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment.
Wellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs.
Voluntary benefits that include accident, critical illness, and hospital indemnity.
Employee discount and rewards program on travel, tickets, electronics, home, and more.