Workers’ Compensation Team Lead - Janie

Workers' Compensation Team Lead

The Workers' Compensation Team Lead oversees daily operations of the WC claims team to ensure efficient, compliant, and timely handling of workers' compensation claims. This role acts as a subject matter expert, provides leadership and coaching to team members, ensures regulatory compliance, and supports process improvement initiatives while maintaining high service standards for employees, employers, and stakeholders. The Team Lead also serves as a key liaison between offshore teams and onsite leadership, ensuring operational alignment, quality performance, and effective communication across departments.

Key Responsibilities:

• Leadership & Team Management
• Lead, coach, and mentor WC claims staff to improve performance, productivity, and technical accuracy
• Assign and monitor workloads to ensure timely claim processing and resolution
• Conduct regular team meetings, case reviews, and performance check-ins
• Support onboarding, training, and ongoing development of new and existing team members
• Collaborate closely with onsite managers and other team leads to align operational priorities, share updates, and resolve workflow challenges
• Monitor team productivity, utilization, and idle time to ensure optimal engagement and accountability during working hours
• Track team attendance, system logins, and working activity to ensure adherence to operational schedules
• Promptly notify onsite managers in the event of unexpected system logouts, connectivity issues, or any other technical disruptions affecting team productivity or availability
• Claims Oversight
• Ensure accurate investigation, documentation, and resolution of claims
• Provide guidance on compensability, reserving, benefits, return-to-work, and settlements
• Escalate high-risk cases and trends to management proactively
• Compliance & Quality
• Ensure compliance with state, federal, and company WC regulations and policies
• Partner with Quality Assurance teams to review audit findings and identify improvement opportunities
• Communicate quality feedback to team members and implement corrective coaching or training as needed
• Monitor audit results and implement corrective actions to maintain high quality and compliance standards
• Maintain quality assurance benchmarks and drive continuous improvement initiatives across the team
• Stakeholder Coordination
• Act as primary escalation contact for internal teams, employees, employers, adjusters, medical providers, and legal counsel
• Ensure effective communication between offshore operations and onsite leadership to maintain service quality and operational consistency
• Reporting & Process Improvement
• Prepare and present reports, dashboards, and trend analysis
• Identify process gaps and implement workflow and technology improvements
• Share daily attendance and availability updates with onsite managers, including agent vacations, approved leaves, and absences to ensure operational transparency and workload planning
• Maintain regular communication with onsite leadership regarding team performance, attendance, and operational updates

Required Qualifications:

• 2+ years of Workers' Compensation claims experience
• 1–2 years of leadership or supervisory experience
• Strong knowledge of WC laws, regulations, and claims best practices
• Experience handling lost-time and complex claims

Preferred Qualifications:

• Experience with WC claims management systems
• Multi-state workers' compensation experience

Key Skills & Competencies:

• Leadership and team development
• Strong analytical and decision-making skills
• Excellent written and verbal communication
• Conflict resolution and negotiation
• Attention to detail and organizational skills
• Ability to manage priorities in a fast-paced environment