Workers' Compensation Third Party Administrator, Claims Manager

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biBerk Business Insurance

WebsiteLinkedInAll Job Openings

51 - 200 employees

🤝 B2B

💸 Finance

B2B • Finance

biBerk Business Insurance is a digital-first insurance provider focused on small business insurance, offering policies such as workers' compensation, professional liability (E&O), general liability, business owners policies (BOP), commercial auto, umbrella, and cyber coverage. Part of the Berkshire Hathaway Insurance Group and backed by A++ rated carriers, biBerk lets small businesses get online quotes, purchase policies, manage claims and documents, and access resources to simplify insurance. The company serves a wide range of small business industries (e. g. , restaurants, retail, contractors, IT, healthcare) and emphasizes instant coverage, cost savings, and direct-to-business underwriting.

📋 Description

• 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

• 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

• 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.