Claims Manager

Role Description

The Claims Manager position at Golden State Claims Adjusters reports to the Senior Vice President of Claims and supervises a team of Claims Supervisors and operational staff. The Claims Manager acts as a liaison between Golden State and our carrier partners and provides strategic and operational leadership on assigned programs to ensure regulatory compliance, operational efficiency, strong claim outcomes, and an exceptional customer experience. This role partners closely with internal stakeholders and external vendors, leverages data and reporting to identify trends and risks, and ensures Best Practices, service standards, and KPIs are consistently met.

Position Responsibilities

• Manage numerous supervisors and adjusters of varying levels of technical experience and is responsible for hiring, onboarding, training, coaching, and performance management.
• Provide leadership and mentoring to adjusters and supervisors, fostering engagement, accountability, professional development, and retention.
• Share responsibility for reviewing all new claim files and assigning them to the appropriate adjuster based on experience level, licensure, and workload.
• Place supervisory notes of a technical nature in each file at the 30-day mark and at least every 90 days thereafter, or more frequently as claim complexity dictates.
• Address escalated complaint calls from clients, insureds, and claimants and collaborate with teams to resolve issues promptly and effectively.
• Conduct claim conferences with adjusters, carrier partners, defense counsel, coverage counsel, and other vendors as needed.
• Review coverage evaluations, coverage letters, reserves, and significant payments to ensure accuracy, timeliness, and compliance with best practices and authority levels.
• Participate in assigned task forces, committees, and cross-functional initiatives focused on continuous improvement and operational effectiveness.
• Conduct training seminars and technical workshops for new and existing employees.
• Carry a pending of key, large exposure, sensitive, or escalated claim files as required.
• Conduct internal audits on a quarterly basis and ensure timely remediation of findings.
• Identify, report, and track Notices of High Potential (NHP) claims and adverse trends.
• Present claim files and operational results at weekly roundtables and leadership meetings.
• Partner with the Senior Vice President of Claims to refine department procedures, workflows, metrics, and KPIs.
• Support audit compliance, resource planning, and staffing needs while driving efficiency and quality outcomes.
• Perform additional duties to support department goals, compliance requirements, and overall claims performance.

Qualifications

• Bachelor’s degree or equivalent combination of education and claims management experience.
• 10+ years of insurance claims experience.
• 5+ years of progressively responsible claims management experience, including litigation exposure.
• Demonstrated experience leading, developing, and supervising claims professionals.
• Strong understanding of California claims regulations; multi-jurisdictional experience a plus.
• Must be licensed as a Qualified Claims Manager in the State of California, with ability to maintain required certifications.
• Strong analytical, organizational, and communication skills with the ability to use data and reporting to drive decisions.
• Proficient computer skills, including Microsoft Outlook, Word, Excel, and claims management systems.
• Background/experience should include: Construction liability, construction defect, GL/PD, GL/BI, Excess, high level coverage evaluation.
• Understanding of claims handling requirements and legal trends in all 50 States.
• NYLL, Energy, Environmental, Transportation experience a plus.

Benefits

• Employee Ownership Program - every eligible employee shares in the financial rewards that grow when the company grows.
• Professional development opportunities.
• Owner Referral Program.
• Work from home reimbursement for remote/hybrid roles.
• Canary emergency financial assistance program.
• Comprehensive medical, dental, vision.
• Life/AD&D Insurance.
• Confidential, Employee Assistance Program.
• Health Savings Account, includes company contribution.
• Short-term disability.
• Voluntary benefits - supplemental accident, critical illness, hospital insurance.
• Employee discounts.
• 401(k) Plan with company match contribution.
• Addition Wealth Financial Wellness Program.
• Various Time Off Programs.
• 11 company paid holidays.