Claims Team Lead - Workers Compensation

About 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.

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 to include two (2) years claims supervisor experience.
• A High School Diploma or GED required.
• A Bachelor's degree from an accredited college or university preferred.
• A professional certification as applicable to line of business preferred.
• Hawaii License and workers comp claims handling experience required.