Claims Supervisor - Workers Compensation

Job Location(s) US-CA-Alhambra
Job ID
2018-1534
# of Openings
1
Category
Worker's Compensation
Job Type
Regular Full-Time

Overview

 

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.

Responsibilities

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

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.

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