Claims Team Lead (Supervisor) - Workers Compensation | Brea, CA

Primary Purpose of the Role

Oversees multiple teams of examiners and technical staff handling workers compensation claims for clients. Manages workloads, provides training, and monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex or high-exposure cases.

Essential Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
• Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
• Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
• Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
• Maintains professional client relationships, offering recommendations and written summaries as needed.
• Safeguards accurate claim coding and documentation by examiners.

Qualifications

• 6 years of claims experience or equivalent combination of education and experience required, including 2 years of claims supervisor experience.
• A High School Diploma or GED is required.
• A Bachelor's degree from an accredited college or university is preferred.
• A professional certification relevant to the line of business is preferred.
• California workers compensation claim handling experience and SIP Certification are required.

Taking Care of You

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401k, and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Work Environment

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding, travel as required.
• Auditory/Visual: Hearing, vision and talking.