Workers Compensation Claims Supervisor

5 - 7 years experience  • 

Salary depends on experience
Posted on 03/21/18
Fresno, CA
5 - 7 years experience
Salary depends on experience
Posted on 03/21/18

As a premier workers’ compensation carrier, we are always mindful that behind every claim is a person who was injured, so an assembly line, rubber-stamp approach doesn’t work. Our claim management philosophy is to create pathways for the best possible results, whether the method is tried and true, or blazes a new path to success. This is The Zenith Difference.   Under general supervision, responsible for the supervision and claims management of a claims unit.  Provides technical guidance and training to personnel.  Evaluates standards of performance of technical and clerical direct reports relative to branch/corporate objectives.

The essential functions of this position include, but are not limited to, the following: 

  • Directs, controls, monitors and provides technical and supervisory guidance to the assigned claims unit(s).
  • Evaluates performance according to established, Zenith’s standards of performance.  Prepares performance appraisals and recommends salary action for staff in unit in accordance with company policy.
  • Participates in interview and hiring process and trains new employees assigned to unit.
  • Responsible for claims management of cases assigned to unit, which may include special accounts, within the guidelines of published performance standards, company claim policy and regulatory requirements.
  • Analyzes claims, sets reserves, determines liability, pays benefits and settles claims within designated dollar authority level and according to company policy and regulatory requirements.
  • Makes timely investigation assignments and rehabilitation referrals including early return to work programs.  Assigns cases to SIU as appropriate.
  • Maximizes utilization of company medical cost containment programs.
  • Prepares cases in litigation adequately and appropriately for MSCs and trials.
  • Communicates with policyholders, injured workers and others in a professional and timely manner.
  • May assist in preparation of agent status reports and policyholder claim reviews.  May be assigned as account coordinator to large policyholders.
  • Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
  • Works productively and harmoniously with others on a consistence basis.
  • Respond positively to direction and criticism of performance.
  • Consistently maintain professional and appropriate demeanor.
  • Perform other duties as assigned. 

Education, Skills and Experience Requirements 

  • Bachelors degree or equivalent combination of training/experiencerequired.
  • Minimum (6) years experience handling workers' compensation indemnity claims; to include settlement negotiation of litigated claimsrequired.
  • Must demonstrate supervisory potential; previous experience or education acquired through seminars and classes preferred.
  • Advanced knowledge of regulatory requirements and prevailing case law required.
  • Excellent verbal and written communication skills necessary.  PC literacy required.
  • Good time management, organizational and negotiation skills a must.
  • Meets all state regulatory standards regarding licensing, continuing education, and other requirements.  

Qualifications

Education

Required

Bachelors or better.

Experience

Required

6 years:Experience handling workers' compensation indemnity claims; to include settlement negotiation of litigated claimsrequired.

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