Claims Supervisor

JT2 Integrated Resources; United States; Presencial; USD 80.000 - 105.000; Jornada completa

Descripción de la vacante

JT2 Integrated Resources is seeking a motivated Claims Supervisor to lead and train teams of examiners and claims support staff under the supervision of the Claims Manager. The position requires supervising tasks, driving performance, and ensuring efficient workflows for our clients.

The role demands seven years’ experience with at least two years as a supervisor, a preferred bachelor’s degree, and current licensing/certification related to California workers’ compensation.

Formación

• Seven years or equivalent experience required, including two years in claims supervision.
• Bachelor’s degree preferred.
• California Self-Insured Plan Certificate required.
• Experience handling Labor Code Section 4850 claims required.
• Must stay current with required educational/training hours.

Responsabilidades

• Schedule and guide teams to ensure timely claims management and compliance.
• Monitor third-party, vocational rehab, and sensitive claims per client instructions.
• Maintain client contact and provide recommendations on claim status.
• Identify roadblocks in claims workflow and propose improvements.
• Assist in recruitment efforts as needed.
• Set performance standards with measurable goals and provide ongoing feedback.
• Provide recommendations on claim management, costs, and litigation management.
• Coordinate projects to meet client needs.
• Analyze management and ad hoc reports and act on findings.
• Ensure direct reports are licensed in serviced jurisdictions.

Conocimientos

Leadership

Communication

Negotiation

Organization

Analytical

Delegation

Educación

Bachelor's degree

Herramientas

Microsoft Office Suite

Descripción del empleo

We are searching for a motivated Claims Supervisor to join our Team!

Under supervision of the Claims Manager, the Claims Supervisor will lead and train teams of examiners and claims support staff. This position requires an individual that can supervise tasks, contribute to the team, and encourage optimum performance of the team.

• Seven (7) years or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
• Bachelor's degree from an accredited college or university preferred.
• Possession of a current California Office of Self Insurance Plans Self-Insured Plan Certificate is required
• Experience handling Labor Code Section 4850 claims is required.
• Current with required educational / training hours

Duties and Responsibilities

• Schedules, prioritizes, and provides guidance to ensure timely execution of claims management to ensure compliance.
• Monitors third party claims; serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
• Maintains contact with the client on claims and makes appropriate recommendations as it relates to claim status.
• Identifies roadblocks and issues relating to claims and workflow management and present solutions on current trends and best practices to improve efficiency.
• Assists and participates in recruitment efforts as needed.
• Sets performance standards by establishing measurable goals and job expectations for assigned staff that facilitates growth and development, and continually monitor, document and present employees with feedback on their performance history as needed
• Provides sound and well-developed recommendations to claims examiners on claim management, compensability issues, cost containment, litigation management, resolution and any sensitive issues as determined by the client
• Coordinates work projects relating to client needs.
• Analyzes and reviews management reports and/or Ad Hoc reports and takes appropriate action.
• Assures that direct reports are properly licensed in the jurisdictions serviced.
• Performs other duties as assigned.

Knowledge, Skills, and Abilities

• Strong knowledge of appropriate principles and laws pursuant to the California WC Laws Practices & Procedures, medical/disability management, SIU/Fraud, litigation rules, Medicare/CMS Rules, and ethical issues.
• Strong knowledge of claims management processes and procedures for public entities and agencies.
• Excellent verbal and written communication skills
• Excellent interpersonal, negotiation, and conflict resolution skills
• Excellent organizational skills and strong attention to detail
• Strong Analytical and problem- solving skills
• Strong ability to prioritize tasks and to delegate when appropriate
• Strong skills with use of general office administration technology, including Microsoft Office Suite and related software
• Ability to act with integrity, professionalism, and confidentiality, at all times

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

JT2 Integrated Resources provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.