Claims Supervisor - Workers Compensation
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Claims Supervisor - Workers CompensationBC Forward is looking for Claims Supervisor - Workers Compensation
Job Title: Claims Supervisor - Workers Compensation
Location: 3633 Inland Empire Boulevard, Ontario, CA 91764
Anticipated Start Date: 01/13
Job Type: 3 Months Contract with Potential Extension
Schedule: Monday to Friday, 8:00 AM to 5:00 PM EST
Work Environment: Hybrid - 2 days in-office per week; first 3 days in-office for training
Pay Rate: $60.00/hr. (on W2)
Job Description:
Job Title: Workers' Compensation Claims Supervisor
Work Location: Hybrid - 2 days in-office per week; first 3 days in-office for training.
Certification Required: SIP Certification
Experience Required: 5+ years of California Workers' Compensation (WC) claims management experience.
Primary Purpose
The Workers' Compensation Claims Supervisor analyzes complex or technically challenging workers' compensation claims to determine benefits, provide guidance to examiners, and manage high-exposure claims involving litigation and rehabilitation. The role ensures claims are adjudicated within service expectations, industry best practices, and specific client requirements, while also identifying subrogation opportunities and negotiating settlements.
Essential Functions and Responsibilities
Claims Management: Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to assess exposure; manage claims through well-developed action plans for timely resolution. Settlements: Approve and negotiate claim settlements within designated authority. Reserves: Calculate and assign appropriate reserves; manage reserve adequacy throughout the claim lifecycle. Payments: Calculate and issue timely and accurate benefits payments; approve adjustments and settle claims within authority levels. Compliance: Prepare and submit necessary state filings within statutory deadlines. Litigation Management: Oversee the litigation process to ensure timely and cost-effective resolutions. Vendor Coordination: Coordinate vendor referrals for additional investigation or litigation management. Cost Containment: Employ strategic cost containment techniques, including partnerships with vendors, to reduce overall claim costs. Recoveries: Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets. Reporting: Report claims to excess carriers and respond to requests promptly and professionally. Communication: Maintain professional relationships with claimants and clients through clear and timely communication. File Management: Ensure claim files are properly documented and coded accurately. Escalation: Refer complex cases to management in accordance with client service instructions. Additional Functions and Responsibilities
Perform other duties as assigned. Support the organization's quality programs. Travel as required. Qualifications
Education & Licensing
Preferred: Bachelor's degree from an accredited institution. Professional certification relevant to the line of business is advantageous. Experience
Minimum 5 years of claims management experience or an equivalent combination of education and experience.Skills & Knowledge
Expertise in workers' compensation insurance principles and laws, recoveries, offsets, and deductions. In-depth understanding of claim and disability duration, medical management practices, and Social Security/Medicare procedures. Proficiency in Microsoft Office and general PC skills. Strong analytical, interpretive, and organizational abilities. Excellent oral and written communication, including presentation skills. Effective negotiation and interpersonal skills. Ability to work collaboratively in a team environment and consistently meet or exceed service expectations. Work Environment
Mental: Ability to think clearly, exercise good judgment, troubleshoot, and handle work-related stress. Capable of managing multiple priorities and meeting deadlines. Physical: Computer keyboarding and travel as required. Auditory/Visual: Clear hearing, vision, and verbal communication skills. Note: Credit security clearance, verified through a background credit check, is required for this position.
This description outlines the general responsibilities and expectations for the role. Management reserves the right to modify duties as necessary to meet organizational needs.
Job Title: Claims Supervisor - Workers Compensation
Location: 3633 Inland Empire Boulevard, Ontario, CA 91764
Anticipated Start Date: 01/13
Job Type: 3 Months Contract with Potential Extension
Schedule: Monday to Friday, 8:00 AM to 5:00 PM EST
Work Environment: Hybrid - 2 days in-office per week; first 3 days in-office for training
Pay Rate: $60.00/hr. (on W2)
Job Description:
Job Title: Workers' Compensation Claims Supervisor
Work Location: Hybrid - 2 days in-office per week; first 3 days in-office for training.
Certification Required: SIP Certification
Experience Required: 5+ years of California Workers' Compensation (WC) claims management experience.
Primary Purpose
The Workers' Compensation Claims Supervisor analyzes complex or technically challenging workers' compensation claims to determine benefits, provide guidance to examiners, and manage high-exposure claims involving litigation and rehabilitation. The role ensures claims are adjudicated within service expectations, industry best practices, and specific client requirements, while also identifying subrogation opportunities and negotiating settlements.
Essential Functions and Responsibilities
Claims Management: Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to assess exposure; manage claims through well-developed action plans for timely resolution. Settlements: Approve and negotiate claim settlements within designated authority. Reserves: Calculate and assign appropriate reserves; manage reserve adequacy throughout the claim lifecycle. Payments: Calculate and issue timely and accurate benefits payments; approve adjustments and settle claims within authority levels. Compliance: Prepare and submit necessary state filings within statutory deadlines. Litigation Management: Oversee the litigation process to ensure timely and cost-effective resolutions. Vendor Coordination: Coordinate vendor referrals for additional investigation or litigation management. Cost Containment: Employ strategic cost containment techniques, including partnerships with vendors, to reduce overall claim costs. Recoveries: Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets. Reporting: Report claims to excess carriers and respond to requests promptly and professionally. Communication: Maintain professional relationships with claimants and clients through clear and timely communication. File Management: Ensure claim files are properly documented and coded accurately. Escalation: Refer complex cases to management in accordance with client service instructions. Additional Functions and Responsibilities
Perform other duties as assigned. Support the organization's quality programs. Travel as required. Qualifications
Education & Licensing
Preferred: Bachelor's degree from an accredited institution. Professional certification relevant to the line of business is advantageous. Experience
Minimum 5 years of claims management experience or an equivalent combination of education and experience.Skills & Knowledge
Expertise in workers' compensation insurance principles and laws, recoveries, offsets, and deductions. In-depth understanding of claim and disability duration, medical management practices, and Social Security/Medicare procedures. Proficiency in Microsoft Office and general PC skills. Strong analytical, interpretive, and organizational abilities. Excellent oral and written communication, including presentation skills. Effective negotiation and interpersonal skills. Ability to work collaboratively in a team environment and consistently meet or exceed service expectations. Work Environment
Mental: Ability to think clearly, exercise good judgment, troubleshoot, and handle work-related stress. Capable of managing multiple priorities and meeting deadlines. Physical: Computer keyboarding and travel as required. Auditory/Visual: Clear hearing, vision, and verbal communication skills. Note: Credit security clearance, verified through a background credit check, is required for this position.
This description outlines the general responsibilities and expectations for the role. Management reserves the right to modify duties as necessary to meet organizational needs.
Interested candidates please send resume in Word format Please reference job code 233772 when responding to this ad.
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