Claims Supervisor - Workers Comp
Employment Type : Full-Time
Job DescriptionJob Title: Claims Supervisor Department: Workers’ Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Class: 14 ATHENS COMPANY DETAILSSince our founding in 1976, Athens Administrators has been a recognized leader in third party claims administration services. But more important than what we do is how we do it. We provide service that translates into real and lasting benefits—every single day. With offices in California, Texas, New Jersey, and Florida; Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. JOB SUMMARYAthens Administrators has an immediate need for a full-time Claims Supervisor to support our San Diego office located on Camino Del Rio So. We are currently working from home until it is deemed safe to return. The Claims Supervisor will supervise and monitor the accuracy, timeliness and quality of casework in assigned unit. In addition, they will develop and maintain a positive and productive working relationship with our clients. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. PRINCIPAL DUTIES AND RESPONSIBILITIESIncumbent must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation:- Work with management to achieve company initiatives and performance goals
- Work with clients with issues regarding policies, programs and/or claims
- Supervise daily activities of team
- Coordinate and perform training
- Interview, hire and train employees
- Provide general guidance to staff
- Review performance of staff
- Resolve team/workflow problems
- Lead staff unit meetings
- Attend client meetings, in-house meetings and workers’ compensation meetings
- Authorize release of payment and settlement
- Make daily claims decisions regarding plan of action, handling of payment, etc.
- Review claim files for accuracy
- Run reports
- Approve payments and reserve increases when they rise above Examiner’s authority level
- Work collaboratively with Athens’ Administrators and clients’ senior management
- Provide information to clients, attorneys, doctors, investigators and injured workers
- Work collaboratively with attorneys to draft settlements and assist with litigation strategies
- Discuss appropriateness of medical treatment with medical case manager
- Assures consistent and accurate claims coding is occurring throughout the organization.
- Other duties as assigned
ACCOUNTABILITIESSupervisory ResponsibilitiesSupervising, scheduling, assigning, monitoring and evaluating work of assigned staff are responsibilities for supervisory positions.- Provide direct supervision to Sr. Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees.
- Review and approve direct report’s monthly expense reports.
ESSENTIAL JOB REQUIREMENTSThe requirements listed below are representative of the knowledge, skill, and/or ability required.Education- High school diploma required, college degree preferred
- Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
- Administrators Certificate from Self-Insurance Plans
- Completion of IEA or equivalent courses
- Solid and in-depth knowledge of workers’ compensation laws, policies and procedures
Experience and Abilities- 3+ years recent workers compensation claims handling experience
- 5+ years’ experience in a Workers’ Comp claims lead or supervisor position preferred
- Proficiency in determining case value and negotiating settlements
- Prior Third Party Administrator (TPA) experience preferred
- Understanding of medical and legal terminology
- Well-developed verbal and written communication skills, ability to follow directions, work under difficult time restraints, prioritize work, and exercise teamwork attitude.
- Strong attention to detail and organizational skills and the ability to research and resolve problems and meet multiple deadlines and to plan and effectuate short and long range Company and department objectives.
- Maintain confidentiality of information.
- Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency.
- Ability to manage multiple tasks simultaneously in a paperless environment
- Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing to execute tasks
- Handles stressful situations and deadline pressures well
- Must demonstrate accuracy and thoroughness in work product
- Ability to operate standard office equipment (fax, phone, printer, scanner, etc.)
- Ability to sit for prolonged periods of time
- Infrequent lifting of up to 20lbs may be required
- Effectively influence people to achieve unit and organizational objectives
- Must be flexible, adaptable, and positive. Exhibit passion and energy for ensuring that all employees are respected and treated in a manner consistent with Athens Values.
- Able to plan, prioritize and organize claims workload for a unit
- Computer literate and experience navigating various computer systems, including MS Word, Excel and Outlook and database management. ClaimsXpress program experience preferred but not required
- Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency
- Skilled at presenting in small and large group settings
- Ability to create reports as required, using the report writing tools available or creating custom documents.
- Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management and other key stakeholders) to achieve organizational goals
- Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully.
- Able to interpret information from multiple sources and draw logical conclusions; consults others based on analysis of data; able to think strategically and use data findings to consult others for improved business results.
- Negotiating skills
- Mathematical calculating skills
- Exercise independent judgment and analytic ability in solving complex and sensitive problems
- Valid Driver’s license and availability for travel
APPLICATION INSTRUCTIONSIn order to be considered, please submit your resume, cover letter, and application directly through our website at http://www.athensadmin.com/careers/job-openings/ All applications received are reviewed by our in-house Corporate Recruiter. This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. IN CLOSINGWe look forward to reviewing your information. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn and Facebook pages!