Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CA

About the role

Oversees examiners handling workers compensation claims for a dedicated client. 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 examiners, 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 California Workers Compensation claims experience required.
• 2 years of supervisory experience preferred.
• Licensing / Jurisdiction Knowledge: California workers compensation claim handling experience | SIP Certified

Benefits

• 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.