Worker's Compensation Claims Supervisor

Worker's Compensation Claims Supervisor

Hybrid Sacramento - Rancho Cordova, CA 95670

Salary Range $100,000.00 - $110,000.00 Salary/year Level Experienced Position Type Full Time Job Shift Day Category Insurance

Worker's Compensation Claims Supervisor

Please make sure to complete all the questions in the application and continue through to the end in order to sign and submit it.

POSITIONS SUPERVISED :

Directly supervise Claims Examiners and Claims Assistants; may provide oversight to File/Mail Clerks and Administrative Assistants as needed during the assignment.

POSITION SUMMARY:

Under minimal supervision, the Claims Supervisor manages and directs the activities of a dedicated claims unit, ensuring quality results and compliance with applicable state laws and company/client procedures. This assignment requires considerable interaction with the client, management, Claims Examiners, and other TRISTAR staff. Consistent attendance in the office, punctuality, and professional communication are essential to ensure continuity of operations during this leave coverage period.

DUTIES AND RESPONSIBILITIES:

• Directly supervise examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues.
• Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.
• Reviews and approves reserve changes, awards, and payments within Company and Client guidelines.
• Performs file reviews to monitor compliance with policies and laws.
• 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 service instructions are being adhered to.
• Analyzes monthly client reports.
• Facilitates internal and external audits.
• Attend client file-staffing meetings in person or telephonically.
• Other duties as assigned.

* Essential job function.

EQUIPMENT OPERATED/USED : Computer, 10-key, printer, copier, fax machine, and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire.

Qualifications

QUALIFICATIONS REQUIRED:

Education/Experience: Bachelor's degree in related field (preferred); three (3) to five (5) years related experience; or equivalent combination of education and experience.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Technical knowledge of statutory regulations, including rules and procedures relating to California
• 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 the 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.

Here are some of the benefits you can enjoy in this role:

• Medical, Dental, Vision Insurance.
• Life and Disability Insurance.
• 401(k) Plan
• Paid Holidays
• Paid Time Off.
• Referral bonus.

Mental and Physical Requirements : [see separate attachment for a copy of the checklist of mental and physical requirements]

TRISTAR Insurance Group