Workers' Compensation Claim Supervisor

Job Summary

The Workers' Compensation Claim Supervisor is responsible for leading a team of approximately seven claim professionals while overseeing the investigation, adjustment, and administration of assigned workers' compensation claims. This role manages multiple client accounts spanning various industries and is accountable for delivering exceptional claim service, maintaining client satisfaction, and ensuring adherence to CCMSI Corporate Claim Standards.

Responsibilities

• Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.
• Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.
• Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
• Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Absorb and supervise the selection, referral and supervision of designated claim files sent to outside vendors (i.e. legal, surveillance, case management, etc.).
• Direct handling of designated litigated and complex claims.
• Provide education, training and assist in the development of claim staff.
• Review and maintain personal diary on claim system.
• Supervision of all claim activity for specified accounts.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications

• 10+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• 3 or more years of supervisory experience.
• Demonstrated ability to lead and oversee adjusters in a fast-paced, compliance-driven environment while maintaining quality and service standards.
• Strong understanding of California Workers’ Compensation regulations, claim practices, and compliance requirements.
• Active Workers’ Compensation adjuster license in California or SIP. If not currently licensed, ability to obtain within allotted time.
• Effective communication skills with the ability to engage professionally with adjusters, clients, and internal partners.
• Working knowledge of entry- and mid-level WC adjusting roles and workflows.

Nice to Have

• Bachelor’s degree or equivalent combination of education and experience.
• Industry certifications (AIC, CPCU, ARM preferred).
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.