WC Claims Lead Examiner

Lead Claims Examiner

**Preference given to those who meet the qualifications and are located in Central or Eastern time zone. ADP is hiring a Lead Claims Examiner.

In this position you will perform the following basic functions:

• Supervisory responsibility for Claims Examiner I and Senior Examiner
• To aid in overall claim cost reduction by coordinating efforts between all involved vendors, clients and WES.
• Additional level to monitor applicable claims assigned to Claims Examiner I and Senior Examiner
• To ensure TPA/Carrier accountability in agreed performance standards and coordinate needs for changes with Claims Director
• To accumulate data for the purpose of creating standards for measurement of various claim related issues, as well as customer service and internal staff performance

At ADP we are driven by your success. We engage your unique talents and perspectives. We welcome your ideas on how to do things differently and better. In your efforts to achieve, learn and grow, we support you all the way. If success motivates you, you belong at ADP. We strive for every interaction to be driven by our

values: Insightful Expertise, Integrity is Everything, Service Excellence, Inspiring Innovation, Each Person Counts, Results-Driven, Social Responsibility.

RESPONSIBILITIES:

• Reviews and recommends acceptability of all Workers' Compensation Claims within claim distribution
• Accountability for the Claim Unit's efforts in all RTW efforts, OSHA documentation and all documentation of claim activity according to stated claim procedures.
• Works directly with Claims Director to determine workloads and the necessity of procedure changes within the Claims Unit
• Assists in online audits of TPA to insure quality compliance of claim procedures and client satisfaction in Workers' Compensation claims handling.
• Maintaining e-time and PTO/Sick time coordination for the Claims Unit., has one administrative direct report and mentor/coaching responsibilities for the Claims Examiner.
• Responsible for communication with internal/external clients, claimants, related vendors as well as TPA/Carrier activity for TotalSource work-site employee claims to include personal visits to each region.
• Requires basic knowledge of Workers' Compensation laws for all jurisdictions.
• Attends professional development courses and seminars to keep TotalSource current with related workers' compensation laws and standards.
• Represents client in legal activities related to Workers' Compensation Claims within authority.
• To review, audit and support the examiner positions.
• To generate routine reports for productivity level evaluation.
• To support the Claims Director in daily/monthly/quarterly tasks and projects that aid in the claim operation reach it's specified goals.

TO SUCCEED IN THIS ROLE: Required Qualifications

• 5 years WC Indemnity adjusting or industry related experience
• Maintain knowledge of basis Workers Compensation Laws in applicable jurisdictions- OH, MI, IN, KY, WV, VA, ME
• Direct or indirect leadership/supervisory experience

A college degree is great but not required. What's more important is having the skills to do the job. If you don't have a college degree, other acceptable experiences could include:

• Experience noted above, OR
• Military experience where skills including teamwork, adaptability, organization, and follow-through will help you build team and client relationships, identify solutions, and achieve success

BONUS POINTS FOR THESE: Preferred Qualifications

• PEO experience
• Stay abreast of strategies and current industry related ideologies in dealing with Workers' Compensation Claims
• Maintain adequate resources to enable continued education in Workers' Compensation and RTW issues