WC Team Lead

Jobtailor; Naperville (IL); On-site; USD 85,000 - 110,000; Full time

Job summary

Jobtailor in Naperville, IL seeks a seasoned Claims Manager to supervise multiple teams of workers' compensation examiners and support staff. You will monitor workloads, coordinate training, and provide direction on adjudication while driving process improvements and ensuring compliance.

You will lead performance development, review complex claims, and partner with management to optimize workflows across multiple product lines. Relevant licenses and certifications are preferred for this role.

Qualifications

• Six years of claims experience or an equivalent combination of education and experience.
• Two years of claims supervisor experience.
• Bachelor's degree preferred.
• Licenses as required for the line of business.
• Professional certifications preferred.
• Strong knowledge of claims management processes across multiple product lines.
• Excellent oral and written communication, including presentation skills.
• PC literacy with Microsoft Office.

Responsibilities

• Supervise multiple teams of workers compensation examiners and technical staff.
• Monitor workloads, provide training, and monitor individual claim activities.
• Provide direction for examiner reports on claims adjudication.
• Identify trends and issues; recommend actions to management.
• Coordinate office projects and process improvement initiatives.
• Compile, review, and analyze management reports and take action.
• Perform quality reviews on claims according to standards.
• Act as second level of appeal for client and claimant issues.
• Review reserves on high-cost claims and claims exceeding authority.
• Monitor third-party claims and review litigated or sensitive claims.
• Maintain client contact and provide written claim resumes.
• Ensure staff licensing, proper coding, and documentation.
• Administer personnel policies, interview/hire, and develop performance plans.
• Conduct performance discussions and provide guidance and motivation.
• Support organizational quality programs and other duties.

Skills

Leadership

Communication

Team collaboration

Analytical skills

Negotiation

Organizational skills

Mentoring

Claims management

Claims adjudication

Quality review

Process improvement

Licensing compliance

Reporting

Training development

Microsoft Office

Education

Bachelor's degree

Licenses as required

Professional certifications

Job description

• Supervise multiple teams of workers compensation examiners and technical staff


• Monitor colleagues' workloads, provide training, and monitor individual claim activities


• Provide technical and jurisdictional direction for examiner reports on claims adjudication


• Identify trends, problems, and issues and recommend courses of action to management


• Coordinate office projects and continuous process improvement initiatives


• Compile, review, and analyze management reports and take appropriate action


• Perform quality reviews on claims according to audit, service contract, and quality standards


• Act as the second level of appeal for client and claimant issues and implement final appeal dispositions


• Review reserves on high-cost claims and claims exceeding examiner authority


• Monitor third-party claims and review litigated, serious vocational rehabilitation, questionable, and sensitive claims


• Maintain client contact, recommend actions based on claim status, and provide written claim resumes


• Ensure direct reports are properly licensed in serviced jurisdictions


• Ensure claims files are correctly coded and adequately documented


• Administer personnel policies, interview and hire colleagues, and establish performance development plans


• Conduct performance discussions and provide support, guidance, leadership, and motivation


• Support organizational quality programs and perform other assigned duties

Requirements

• Six (6) years of claims experience or equivalent combination of education and experience required


• Two (2) years of claims supervisor experience required


• Bachelor's degree from an accredited college or university preferred


• Licenses as required


• Professional certifications applicable to the line of business preferred


• Thorough knowledge of claims management processes and procedures for multiple product lines


• Excellent oral and written communication, including presentation skills


• PC literacy, including Microsoft Office products


• Leadership, management, and motivational skills


• Analytical and interpretive skills


• Strong organizational skills


• Excellent interpersonal skills


• Excellent negotiation skills


• Ability to work in a team environment


• Ability to meet or exceed Performance Competencies


• Ability to handle multiple priorities and meet deadlines


• Ability to travel as required

Core Competencies

Demonstrates extensive experience in claims management processes and procedures, with a strong focus on leadership, team supervision, and performance development. Proficient in analyzing claims data, providing technical direction, and ensuring compliance with quality standards.

Highest-signal resume keywords

• Claims Management


• Claims Supervisor Experience


• Leadership Skills


• Analytical Skills


• Microsoft Office Proficiency

ATS Optimization Keywords

Hard Skills

• Claims Adjudication


• Quality Review


• Performance Competencies


• Claims Analysis


• Process Improvement


• Licensing Compliance


• Claims Coding


• Report Compilation


• Training and Development


• Negotiation

Soft Skills

• Excellent Communication


• Interpersonal Skills


• Organizational Skills


• Motivational Skills


• Team Collaboration

Certifications & Qualifications

• Professional Certifications

Industry Keywords

• Workers Compensation


• Claims Experience


• Performance Development Plans


• Third-Party Claims


• Vocational Rehabilitation