Claims Team Lead - Workers Compensation (HYBRID- Roseville, CA)

About the role

Dedicated CA self-insured client. CA self-insured certificate required and candidate must reside and work in CA.

Responsibilities

• 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, 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 & workers comp claims handling experience.