What are the responsibilities and job description for the Workers' Compensation TPA Oversight Claims Supervisor position at KING'S INSURANCE STAFFING LLC?
Our client, a National Insurance Carrier, is seeking to add a Workers’ Compensation TPA Oversight Manager to their North Carolina operations. This individual will be responsible for overseeing Workers’ Compensation claims being handled by Third-Party Administrators (TPAs), while also providing technical direction and oversight related to claim handling strategy, reserving, settlement authority, litigation management, and overall TPA performance.
This position will play a critical role in supervising complex and high exposure claims, ensuring compliance with carrier best practices, identifying trends and opportunities for operational improvement, and partnering closely with claims professionals, attorneys, nurse case managers, and senior leadership. The ideal candidate will be located in the Greater Charlotte area and bring strong Workers’ Compensation claims experience along with prior oversight or supervisory experience.
Key Responsibilities:
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Oversee and supervise Workers’ Compensation claims being handled by TPAs.
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Monitor, audit, and evaluate TPA claim handling performance while partnering with adjusters, defense counsel, medical management vendors, and internal stakeholders to establish appropriate claim strategies.
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Review claim files for proper documentation, compensability analysis, reserving accuracy, litigation management, settlement strategy, and overall claim progression.
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Approve reserve increases and settlements exceeding established TPA authority levels.
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Perform detailed TPA claim audits, identify trends, calculate overpayment percentages, and develop corrective action plans and performance improvement recommendations.
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Provide leadership and technical guidance on complex Workers’ Compensation claims involving severe injuries, lost time exposures, litigation, and catastrophic losses.
Requirements:
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5 – 10 years of Workers’ Compensation claims experience.
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Prior experience overseeing TPA claim handling strongly preferred.
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Previous leadership, mentoring, supervisory, or team lead experience preferred.
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Strong understanding of Workers’ Compensation laws, Commercial Auto exposures, coverage evaluation, litigation management, reserving, and settlement strategy.
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Experience handling multi-jurisdictional claims and high exposure losses.
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Strong verbal and written communication skills, including the ability to present information effectively to leadership and external partners.
Salary / Benefits:
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$90,000 – $105,000 annual base salary plus bonus
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Extremely competitive Medical, Dental, Vision, and Life plans
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Employer covers 100% of employee health benefits
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Employer matching 401(k) plan
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Lucrative PTO plan
Salary : $90,000 - $105,000