Workers' Claims Supervisor

Workers' Compensation Claims Supervisor

Hybrid Denver - Lakewood, CO 80228

Salary Range $85,000.00 - $95,000.00 Salary/year Level Management Position Type Full Time Job Shift Day Category Insurance

Hybrid in/out of office, depending on requirements for the office

POSITIONS SUPERVISED:
Directly:
Claims Examiners, Claims Assistants; may supervise File/Mail Clerks and Administrative Assistants

POSITION SUMMARY:

This position requires considerable interaction with the client, management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work in the office, in a timely manner, is inherently required of this position.

• Directly supervises examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues.
• Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.
• Reviews and approves reserve changes, awards, and payments within Company and Client guidelines.
• Performs file reviews to monitor compliance with policies and laws.
• Establishes appropriate supervisory diaries on claim files and completes pending diaries on or before scheduled due dates.
• Prepares for claim audits, reviews audit results, and provides appropriate rebuttal feedback.
• Coordinates and leads training sessions for staff on updated laws, policies, and procedures.
• Ensures daily caseload staffing requirements are met.
• Responds to claimant and vendor concerns and issues as needed.
• Ensures client servicing instructions are being adhered to.
• Analyzes monthly client reports.
• Facilitates internal and external audits.
• Attends client file-staffing meetings in-person or telephonically.
• Other duties as assigned.

* Essential job function.

Computer, 10-key, printer, copier, fax machine and other office equipment.

Appropriate office attire.

Education/

Experience:

Bachelor's degree in related field (preferred); three (3) to five (5) years related experience; or equivalent combination of education and experience.

• Technical knowledge of statutory regulations.
• Ability to work on a diary system, prioritize tasks and meet strict deadlines.
• Strong analytical skills.
• Proficient in Word and Excel.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
• Ability to manage employees of various skill levels.
• Excellent interpersonal skills.

• Certifications and/or licenses as required by State regulation.

• Medical, Dental, Vision Insurance.
• Life and Disability Insurance.
• 401(k) Plan
• Paid Holidays
• Paid Time Off.
• Referral bonus.

1. MENTAL EFFORTa. Reasoning development:

Follow one- or two-step instructions; routine, repetitive task.

Carry out detailed but uninvolved written or verbal instructions; deal with a few concrete variables.

Follow written, verbal, or diagrammatic instructions; several concrete variables.

X Solve practical problems; variety of variables with limited standardization; interpret instructions.

Logical or scientific thinking to solve problems; several abstract and concrete variables.

Wide range of intellectual and practical problems; comprehend most obscure concepts.

b. Mathematical development:

Simple addition and subtraction; copying figures, counting, and recording.

Add, subtract, multiply, and divide whole numbers.

X Arithmetic calculations involving fractions, decimals, and percentages.

Arithmetic, algebraic, and geometric calculations.

Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

Highly complex mathematical and statistical techniques, such as calculus, factor analysis, and probability determination; requires theoretical application.

c. Language development:

Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic…