Workers Compensation Claims Director
About the role
We are seeking a Director of Claims, Workers' Compensation for a hybrid role based in Raleigh, NC.
Responsibilities
Own the financial performance of the Workers' Compensation portfolio, including loss ratio, reserve adequacy, and claim duration targets.
Partner with the VP of Claims to develop and execute annual department strategy, operating plans, and budgets.
Conduct portfolio-level loss trend analyses to identify severity drivers, emerging exposures, and state-level outliers.
Provide technical leadership on complex and catastrophic claims, including reserve/settlement authority and litigation strategy.
Assess and build claims operational readiness to support planned expansion into new state markets.
Leverage claims data and predictive analytics to inform reserving, litigation, and settlement strategies.
Lead, coach, and develop a high-performing claims team, fostering a culture of technical excellence and accountability.
Drive adoption of innovative solutions, including AI-assisted analytics and automation, to enhance file handling efficiency.
Govern third-party vendor relationships (SIU, medical management, defense counsel) for performance and cost-effectiveness.
Collaborate cross-functionally with Underwriting, Actuarial, and Legal to address service, profitability, and litigation risk.
Requirements
Bachelor's degree preferred and minimum of 10 years of insurance company claims experience, or an equivalent combination of education and experience.
Completed industry designations such as AIC, CPCU are a plus.
Five (5) or more years of progressive management experience in a Workers' Compensation claims operations environment.
Prior construction-related, multi-jurisdictional Workers' Compensation claims management experience is preferred.
Demonstrated ability to own financial results, including loss ratio and reserve accuracy, and to translate data analysis into actionable strategy.
Sound judgment, initiative, and ownership in leading complex, multi-jurisdictional claims and cross-functional projects.
Strong verbal and written communication skills, including the ability to present findings and recommendations to executive leadership.
Ability to design and map claims workflows for greater efficiency, and to lead process or technology change.
Demonstrated executive presence and ability to influence senior leadership through data-driven recommendations.
Skills
Bachelor's degree preferred and minimum of 10 years of insurance company claims experience, or an equivalent combination of education and experience.
Completed industry designations such as AIC, CPCU are a plus.
Five (5) or more years of progressive management experience in a Workers' Compensation claims operations environment.
Prior construction-related, multi-jurisdictional Workers' Compensation claims management experience is preferred.
Demonstrated ability to own financial results, including loss ratio and reserve accuracy, and to translate data analysis into actionable strategy.
Sound judgment, initiative, and ownership in leading complex, multi-jurisdictional claims and cross-functional projects.
Strong verbal and written communication skills, including the ability to present findings and recommendations to executive leadership.
Ability to design and map claims workflows for greater efficiency, and to lead process or technology change.
Demonstrated executive presence and ability to influence senior leadership through data-driven recommendations.