Claims Supervisor - Workers Compensation

POSITIONS SUPERVISED:  Directly: Claims Examiners, Claims Assistants; may supervise File/Mail Clerks and Administrative Assistants

POSITION SUMMARY:  Under minimal supervision, manages and directs activity of claims unit ensuring high-quality results and management of claims in compliance with state laws and company/client procedures.  This position requires considerable interaction with the client, management, claims examiners, and other TRISTAR staff in the office; therefore, consistently being in the office in a timely manner is inherently required of this position.

DUTIES AND RESPONSIBILITIES:

• Directly supervises examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues.*
• Reviews and approves reserve changes, awards and payments based upon City of Los Angeles claims handling instructions.*
• Complete supervisor reviews to ensure compliance based on state laws and TRISTAR best practices.*
• Establishes appropriate supervisory diaries on claim files and completes pending diaries on or before scheduled due dates.*
• Prepares for claim audits, reviews audit results, and provides appropriate rebuttal feedback.*
• Coordinates and leads training sessions for staff on updated laws, policies, and procedures.*
• Ensures daily caseload staffing requirements are met.*
• Responds to claimant and vendor concerns and issues as needed.*
• Ensures client servicing instructions are being adhered to.*
• Facilitates internal and external audits.*
• Other duties as assigned.
• Responsible for all personnel transactions for subordinates assigned to them (time cards, PTO requests, performance reviews and administrative actions).*

*Essential job function.

QUALIFICATIONS REQUIRED:

Education/Experience: Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

• Technical knowledge of statutory regulations.
• Ability to work on a diary system, prioritize tasks and meet strict deadlines.
• Strong analytical skills.
• Proficient in Word and Excel.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
• Ability to manage employees of various skill levels.
• Excellent interpersonal skills.

Other Qualifications:

• Certifications and/or licenses as required by State regulation.