Senior Workers' Comp Claims Leader

TRISTAR RISK MANAGEMENT; Rancho Cordova (CA); On-site; USD 100,000 - 110,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Life and Disability Insurance

401(k) Plan

Paid Holidays

Paid Time Off

Referral bonus

Job summary

TRISTAR RISK MANAGEMENT in Sacramento/Rancho Cordova, CA, seeks an experienced Claims Supervisor to lead a dedicated claims unit and ensure quality results in compliance with state laws and client procedures.

Under minimal supervision, you will supervise examiners and staff, review claims issues, manage reserves, coordinate audits, and train staff to stay current with changes in regulations. Regular office presence and clear communication are essential.

Qualifications

• Bachelor’s degree in a related field preferred; 3–5 years related experience or equivalent combination.
• Knowledge of statutory regulations affecting California.
• Excellent written and verbal communication skills; ability to convey technical details to claimants, clients, and staff.

Responsibilities

• Directly supervise examiners and clerical staff, monitor attendance and performance.
• Review and address scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.
• Review and approve reserve changes, awards, and payments within Company and Client guidelines.
• Perform file reviews to monitor compliance with policies and laws.
• Establish supervisory diaries on claim files and complete pending diaries on schedule.
• Prepare for claim audits, review audit results, and provide rebuttal feedback.
• Coordinate and lead training sessions for staff on updated laws, policies, and procedures.
• Ensure daily caseload staffing requirements are met.
• Respond to claimant and vendor concerns and issues as needed.
• Ensure client service instructions are being adhered to.
• Attend client file-staffing meetings in person or telephonically.
• Other duties as assigned.

Skills

Statutory regulations knowledge

Diary system prioritization

Analytical skills

Word/Excel proficiency

Written and verbal communication

People management

Education

Bachelor's degree in related field

Tools

Word

Excel

Job description

TRISTAR RISK MANAGEMENT in Sacramento/Rancho Cordova, CA, seeks an experienced Claims Supervisor to lead a dedicated claims unit and ensure quality results in compliance with state laws and client procedures.

Under minimal supervision, you will supervise examiners and staff, review claims issues, manage reserves, coordinate audits, and train staff to stay current with changes in regulations. Regular office presence and clear communication are essential.