Claims Operations Lead

Introduction Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations.

In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional.

Overview

Oversee Claims Clerical and Administrative operations. Supervision of Claims Assistants.

This role is responsible for managing the utilization review and medical treatment requests

• Oversee day-to- day operation and coordination of Claims Assistants.
• This role is responsible for managing the utilization review and medical treatment requests.
• Ensure timely workflow and prioritization of clerical tasks, management of diary, and the appropriate training or matching of task complexity to staff capabilities.
• Manage the Coming Full Circle process for each direct report – complete Setting Expectations, mid-year check-in, and year-end review process timely.
• Ensure that direct reports have clear understanding of expectations around behaviors and results and that those are in alignment with goals and expectations of the larger Claims function.
• Zen Care training, technical administration, process management and quality oversite.
• Support Claim Assistant goals, evaluate training needs, and ensure compliance with performance standards.
• Assist Claims branch with hiring, promotions, and disciplinary actions if necessary of Claim Assistants.
• Responsible for training new Claims administration staff on day-to-day role and accountabilities.
• Create and sustain an environment that motivates team members to achieve desired results.
• Work closely with Claims leadership and corporate leadership to ensure support staff understands how they contribute to corporate objectives and execute on their objectives.
• Perform other duties and projects as assigned.
• Model and maintain superior customer service practices for internal and external partners in line with Zenith value proposition and success profile at superior level.
• Provide coaching and feedback to clerical team members; ensure appropriate skills and knowledge exist.
• Understand, identify and implement process improvement strategies to include assistance with system changes and/or enhancements.
• Work closely with our technology leaders to implement better efficiencies.
• Assist to bridge new technologies for Claims developed by our leaders in technology and business process improvement.
• Maintain updated job description, day-to-day accountabilities, and setting expectations documents for Claims Assistants.

• High School Diploma Or equivalent required
• Bachelor’s Degree or equivalent business experience required

• 3+ years Previous experience handling/managing Workers’ Compensation clerical and administrative duties required

• Prior supervisory experience or 3 year’s work experience demonstrating expert-level knowledge of technical workers compensation processes and support staff functions.

• Experience with a medical background, preferably utilization review in CA and out of state jurisdictions strongly preferred.

• Excellent verbal and written communication skill necessary.
• Ability to work independently, travel to various offices and establish rapport quickly with all staff.
• Work experience demonstrating effective time management, organizational and collaborative skills a must.

The expected salary range for this position is $85,736 - $107,170. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level.Benefits

• Medical, Dental and…