Claims Department Senior (Worker's Compensation) On-site

About the Role

The Claims Department is responsible for the efficient administration of the initial post-filing phase of a claim — the period during which insurance carriers are actively investigating. This includes correctly setting up claims with carriers, obtaining claim numbers and status updates, conducting employment and coverage investigations, and filing amendments to applications with the court. The Claims Department Senior plays a key role in keeping the department running smoothly and efficiently. This person audits case workflows, leads solutions on flagged issues, mentors team members on process and strategy, and manages the department's shared inbox to ensure nothing falls through the cracks. This is a hands-on leadership role for someone who thrives on solving problems and keeping high-volume work moving.

Responsibilities

• Workflow Audits & Case Solutions
  • Conduct daily audits of cases in workflows to identify bottlenecks, errors, or stalled matters
  • Lead and implement solutions to move flagged cases forward
  • Track recurring issues and recommend process improvements
• Supervisor Collaboration
  • Meet weekly with the Claims Department Supervisor to review audit findings
  • Discuss and help develop administrative strategies to advance matters efficiently
• Team Mentorship
  • Serve as a go-to resource for team members' questions on claims processes and procedures
  • Coach team members on administrative strategies for resolving common issues
  • Help onboard and train newer staff as needed
• Department Inbox Management
  • Review and triage the department's shared inbox
  • Identify required actions and assign or complete them promptly
  • Ensure all inbox items are tracked through to completion
• Core Claims Functions
  • Set up claims correctly with insurance carriers
  • Obtain and track claim numbers and claim statuses
  • Conduct employment and coverage investigations
  • Prepare and file amendments to applications with the court
• Other duties as assigned by supervisor

Qualifications

• Strong problem-solving skills and sound judgment under time pressure
• Fast learner, comfortable picking up new systems and processes quickly
• Proven ability to manage high-volume caseloads without sacrificing accuracy
• Critical thinker who can identify root causes, not just symptoms
• Bilingual (English/Spanish) required
• Comfortable mentoring and supporting colleagues
• Strong organizational skills and attention to detail
• Prior insurance claims experience helpful, but not required

Benefits

• Medical, dental, and vision insurance coverage
• Flexible time off plans, including Paid Time Off (PTO) and paid holidays

Compensation

$27.00 - $37.00 hourly depending on experience

Employment Type

Full Time

Location

California

Workplace type

On-site