Workers Compensation Claims Team Lead

About the role

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. This role involves supervising the operation of multiple teams of examiners and technical staff for workers compensation, monitoring workloads, providing training, and overseeing claim activities. You will provide technical and jurisdictional direction for claims adjudication and maintain diaries on complex or high-exposure claims.

Responsibilities

• Supervises multiple teams of examiners, product line examiners, and/or technical operations colleagues (minimum seven) for a wide span of control; may delegate duties within the unit.
• Identifies and advises management of trends, problems, and issues, recommending courses of action; informs management of new procedures and ideas for continuous process improvement.
• Provides technical and jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews, and analyzes management reports and takes appropriate action.
• Performs quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as the second level of appeal for client and claimant issues regarding claim-specific, procedural, or special requests; implements final disposition of appeals.
• Reviews reserve amounts on high-cost claims and claims exceeding the examiner’s authority.
• Monitors third-party claims, litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as determined by the client.
• Maintains contact with clients on claims, promotes professional relationships, and provides written resumes of specific claims as requested.
• Ensures direct reports are properly licensed in the jurisdictions serviced.
• Ensures claims files are coded correctly and adequately documented by claims examiners.

Supervisory Responsibilities

• Administers company personnel policies and follows staffing standards and training recommendations.
• Interviews, hires, and establishes colleague performance development plans; conducts performance discussions.
• Provides support, guidance, leadership, and motivation to promote maximum performance.

Requirements

• 5 years of Workers Compensation claims management experience or equivalent combination of education and experience required.
• Supervisory experience preferred.
• High School Diploma or GED required; Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to the line of business preferred.
• Jurisdiction knowledge required: FL, GA, IN, KY, NC, SC, TN, VA.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• Comprehensive benefits offering including medical, dental, vision, and 401K (available on day one).
• Additional voluntary benefits such as disability and life insurance, employee assistance, flexible spending or health savings account.

Pay

The range of starting pay for this role is $66,000 - $95,000/yr for the jurisdiction noted in this job posting. Actual compensation is influenced by skill set, level of experience, and cost of specific location.