Responsibilities
As a Claims Team Lead, you will be responsible for the administrative and technical supervision of a team of workers’ compensation claims professionals. We’ll look to you for staff training, development, and performance management; to monitor claim handling activities; and provide technical and jurisdictional specific direction and feedback to ensure timely and accurate investigation and adjudication of claims to produce quality outcomes.
- Supervises all technical aspects of claims including coverage investigation, disability benefits management, medical management, file management, litigation management, subrogation, reserving and settlement.
- Provides team with technical training and claims handling guidance and direction
- Reviews reserve and settlement amounts over the Claims Representative authority level for approval
- Ensures claims are clearly and adequately documented, and ensures claims data is captured and coded correctly within the claims management software system
- Provides team support, leadership and motivation to promote a high level of performance
- Establishes team performance goals and objectives in alignment with business plans
- Directs team toward the achievement of established goals and objectives
- Performs claims quality reviews in compliance with audit requirements and quality standards on a monthly and quarterly basis
- Identifies and alerts senior management to claims trends or issues
- Resolves escalated policyholder and claimant issues related to specific claims
- Conducts regular coaching and performance feedback discussions
- Establishes performance and career development plans in collaboration with team members, management & HR
- Assures claims representatives are properly licensed or certified in assigned jurisdictions
- Partners with HR and management on engagement strategies to improve employee engagement, job satisfaction, and create a psychologically safe work environment
- Administers all company personnel policies and addresses and resolves personnel matters with the support of management and HR
- Conducts interviews of prospective claims representative candidates and provides feedback to assist senior management with hiring decisions
- Maintains and demonstrates knowledge of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions
- Attends and participates in claim file reviews with senior management and defense attorneys
- Coordinates and leads special projects or processes as assigned by senior management
- Continuously strives to improve our product and business results through innovation
- Obtain and maintain adjuster license in multiple jurisdictions
Qualifications
- Minimum 3 years of experience (4 – 5 years preferred) handling workers’ compensation claims in multiple jurisdictions
- Supervisory experience preferred but not required
- Exceptional leadership and motivational skills
- Excellent written, verbal, interpersonal and relationship building skills
- Excellent time management and organization skills
- Strong analytical and critical thinking skills
- Ability to effectively manage and develop talent
- Ability to implement policies, procedures and controls to measure and improve service and financial performance
- Ability to work independently and strategically problem solve
- Ability to diplomatically manage conflict
- Ability to develop relationships within the organization and work effectively across departments
- Strong discretion and integrity in dealing with highly confidential and sensitive information
- Detail oriented
- Ability to quickly learn to intuitively use internal systems
Education Requirement
- Bachelors’ degree or equivalent insurance industry work experience
- AIC, ARM, CCP, or CPCU insurance designation preferred
Additional Company Details*The above job description is not intended to be an “all-inclusive” list of the duties and responsibilities of the job described, nor is it intended to be such a listing of the skills and abilities required to do the job. Rather, it is intended only to describe the general nature of the job. The company offers a competitive compensation plan and robust benefits package for full time regular employees • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. - Base Salary Range: 85k-110k The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Additional RequirementsTravel Requirements Low level of domestic U.S. travel required (up to 10% of time) Ability to travel nationally to attend legal hearings, conferences, trainings, file reviews and audits
