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Claim Supervisor - CA jurisdiction - Hybrid Position

Claim Supervisor - CA jurisdiction - Hybrid Position

**MUST HAVE CALIFORNIA EXPERIENCE**

If interested, please contact Tammy Galey 480-384-5916 or apply online at ccmsi.com 


 

Summary:

 

The Workers’ Compensation Claim Supervisor position is responsible for the investigation, adjustment and supervision of assigned workers’ compensation claims.  This position may be used as an advanced training position for consideration for promotion to a management position.   The position is also accountable for the quality of workers’ compensation claim services as perceived by CCMSI clients and within our Corporate Claim Standards.

 

Essential Duties & Responsibilities:

 

Review, assign and provide supervision of all workers’ compensation claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.


Investigate, evaluate and adjust assigned workers’ compensation claims in accordance with established claim handling standards and laws.


Reserve establishment and/or oversight of reserves for designated workers’ compensation claims within established reserve authority levels.


Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.  Negotiate any disputed bills or invoices for resolution.


Authorize and make payments of workers’ compensation claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.


Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.


Assist designated claim staff in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)


Direct handling of designated litigated and complex claims.


Provide education, training and assist in the development of claim staff.


Review and maintain personal diary on claim system.


Supervision of all workers’ compensation claim activity for specified accounts.


Compliance with Corporate Claim Handling Standards and special client handling instructions as established.


Performs other duties as assigned.

 


Qualifications:


To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Excellent oral and written communication skills. Initiative to set and achieve performance goals.  Good analytic and negotiation skills.  Ability to cope with job pressures in a constantly changing environment.  Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities.  Ability to coordinate and prioritize required.  Flexibility, accuracy, initiative and the ability to work with minimum supervision.  Discretion and confidentiality required.

 

Reliable, predictable attendance within client service hours for the performance of this position.


Responsive to internal and external client needs.


Ability to clearly communicate verbally and/or in writing both internally and externally.

 

Education and/or Experience    

10+ years workers’ compensation claim experience is required.

Three years supervisory experience preferred.

Bachelor’s Degree is preferred.

 

Computer Skills            

Proficient with Microsoft Office programs. 


Certificates, Licenses, Registrations 

Adjuster’s license may be required based upon jurisdiction.

AIC, CPCU, or ARM preferred.


Additional Info

Job Type : Full-Time

Education Level : ""

Experience Level : Mid to Senior Level

Job Function : ""

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