Workers Compensation Claims Team Manager | IL jurisdiction

Insurance Placement Solutions; United States; Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player is seeking a Remote Workers’ Compensation Claims Team Manager to lead and supervise a dynamic team. In this pivotal role, you will leverage your extensive knowledge of workers’ compensation to investigate and resolve claims efficiently while ensuring compliance with legal and company standards. This position offers the opportunity to drive process improvements and maintain strong client relationships, making a significant impact on the claims management process. If you are a seasoned professional with a passion for leading teams and enhancing operational efficiency, this role is perfect for you.

Qualifications

• 5+ years as a workers' compensation adjuster or team lead.
• 2+ years as a supervisor/team manager in workers' compensation.

Responsibilities

• Supervise teams of examiners and manage claims processes.
• Identify trends and recommend actions for continuous improvement.
• Perform quality reviews and ensure compliance with standards.

Skills

Workers' Compensation Knowledge

Claims Investigation

Analytical Skills

Team Leadership

Process Improvement

Education

High School Diploma or Equivalent

Job description

Insurance Placement Solutions has an immediate opening for a Remote Workers’ Compensation Claims Team Manager with our client. As a member of our client’s claims team, utilize your knowledge of workers’ compensation to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer and resolve claims in a timely manner in accordance with legal statutes, policy provisions, and company guidelines.

Workers Compensation Lost Time Claims Team Manager Responsibilities

• Supervises multiple teams of examiners, single or multiple product line examiners, and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
• Identifies and advises management of trends, problems, and issues as well as a recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews, and analyzes management reports and takes appropriate action.
• Performs quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as the second level of appeal for client and claimant issues regarding claim-specific, procedural, or special requests; implements final disposition of the appeal.
• Reviews reserve amounts on high-cost claims and claims over the authority of the individual examiner.
• Monitors third-party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as determined by the client.
• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to the client as suggested by the claim status; and provides written resumes of specific claims as requested by the client.
• Assures that direct reports are properly licensed in the jurisdictions serviced.
• Ensures claims files are coded correctly, and adequate documentation is made by claims examiners.

Experience

• 5+ years experience as a workers’ compensation adjuster and/or team lead
• 2+ years experience as a workers’ compensation supervisor/team manager
• Jurisdictional experience in any of the following states: IL, IN, MI, MN, OH, SD, or WI

Licensing

• An active adjuster license is preferred but not required

Education

• A high school diploma or equivalent is required