Worker’s Comp and Liability Manager

This role collaborates closely with Billing, Sales Support, Compliance, and other cross-functional partners to support timely and accurate processing, strengthen documentation readiness, resolve operational barriers, and improve revenue cycle outcomes. The Manager provides direct leadership, coaching, and accountability to assigned team members while reinforcing company policies, customer service expectations, payer requirements, privacy standards, and established procedures. This role focuses on consistent execution, team development, reporting, issue resolution, and continuous process improvement within the assigned area of responsibility.

• Operational Leadership - Leads the Worker’s Comp and Liability function by setting expectations, aligning priorities, managing performance, and ensuring supervisors and specialists have the direction, tools, and support needed to succeed.
• Documentation Review Governance - Oversees the consistent application of documentation review standards, payer requirements, medical necessity criteria, internal workflows, and escalation protocols.
• Quality & Performance Management - Owns departmental quality, productivity, timeliness, and accuracy outcomes through performance monitoring, reporting, coaching structures, corrective action, and continuous improvement.
• People Development - Develops supervisors, leads, and specialists through structured coaching, training plans, performance feedback, accountability routines, succession planning, and professional growth opportunities.
• Process Improvement & Change Management - Identifies workflow gaps, documentation trends, payer changes, system needs, and operational risks; leads initiatives that improve accuracy, efficiency, scalability, and team adoption.
• Cross-Functional Collaboration - Partners with leadership, claims, authorization, billing, clinical, compliance, sales support, and other internal teams to resolve documentation barriers and improve handoffs across the order lifecycle.
• Compliance & Risk Awareness - Maintains department adherence to privacy standards, documentation requirements, payer guidance, audit expectations, SOPs, and escalation pathways.
• Manage the overall Worker’s Comp and Liability function, including workflow performance, quality outcomes, staffing needs, escalation support, reporting, and operational priorities.
• Provide leadership, direction, coaching, and accountability to supervisors, leads, and Case Workers responsible for reviewing medical records, claims documentation, payer criteria, and related support materials.
• Establish, maintain, and reinforce consistent documentation review standards, quality expectations, escalation pathways, productivity goals, and departmental procedures.
• Monitor departmental performance metrics, including accuracy, timeliness, productivity, backlog, aging, escalation volume, quality trends, and documentation outcomes; communicate results and recommended actions to leadership.
• Lead quality management routines, including audits, calibration discussions, trend reviews, corrective action plans, refresher training, and process updates to improve consistency and reduce preventable errors.
• Oversee escalated documentation issues, payer interpretation questions, operational barriers, and complex cases requiring management review or cross-functional resolution.
• Partner with internal teams to improve documentation handoffs, authorization support, claims readiness, payer response workflows, system usage, case tracking, and communication standards across the order and claims process.
• Identify process gaps, recurring documentation deficiencies, training needs, payer changes, system limitations, and operational risks; develop and implement action plans to address…