Claims Unit Supervisor

ESSENTIAL RESPONSIBILITIES

• Ensures unit achieves organizational goals via prompt claim closures, high client service satisfaction, timely medical management decisions, and strategic cost containment.
• Ensures claim reserves and settlements are appropriate and timely.
• Monitors and directs the management of individual claims within the unit. Ensures claims are managed in compliance with applicable statutes, regulations, case law and Company standards.
• Manages the workflow of the unit, including planning, assigning and directing work.
• Fosters and guides the professional development of individual Claims Professionals of varying levels of experience to help them build successful and satisfying careers while producing excellent results in their work and exhibiting exemplary workplace behavior. This includes establishing and reinforcing goals and expectations; organizing work, processes and assignments that leverage the skills of the team and achieves team outcomes; coaching, developing, and motivating the team effectively, as well as addressing, recognizing and rewarding performance.
• Identifies and communicates training needs. Assists with facilitating training topics and continually reinforces adherence to the concepts and techniques adopted.
• Aids in the development of vendor panels via continual feedback to management as to effectiveness of defense counsel, medical providers (physicians, medical facilities, nurse case managers), and vendors (durable medical equipment vendors, translators, copy services, and vocational rehabilitation service providers).
• Ensures continuing education requirements are met.
• Performs special assignments and projects as assigned.

TECHNICAL/FUNCTIONAL KNOWLEDGE

• Masters the laws and practices of the relevant jurisdictions.
• Assess own strengths and weaknesses.
• Pursues training and development opportunities.
• Works continuously to build skills in planning, communication, and decision-making.
• Shares expertise with others.
• Proficient on the Microsoft Office Suite and able to quickly master proprietary and vended software applications.

REQUIRED QUALIFICATIONS

• Education: Minimum of high school diploma or equivalent educational certification required. Bachelor's degree from an accredited college or university preferred.
• Certifications: Licensed to adjust workers' compensation claims in one or more assigned jurisdictions required. CA Self-Insurance Administrator's (SIP) Certification preferred.
• Experience: Minimum of three (3) years of relevant experience and training, or an equivalent combination of education and experience required. Prior supervisory experience in workers compensation claims management preferred.
• Computer Skills: Proficient on the Microsoft Office Suite and able to quickly master proprietary and vendor software applications.
• Math and Reasoning: Able to solve practical problems and deal with a variety of variables in situations where only limited standardization exists.  Able to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.  Able to calculate figures and amounts such as discounts, interest, proportions, rate, ratio and percent. Familiar with the concept of statistical likelihood as the basis for calculating the value of a possible financial outcome. 
• Language Ability: Able to read and interpret complex documents including statutes, regulations, legal opinions, legal letters, medical records, medical bills, medical resource materials, investigation reports, claim notes, and claim data fields. Able to write clear, concise reports accurately conveying complex, nuanced and technical information. Possesses strong telephonic communication skills including investigation, persuasion, and negotiation. Able to effectively present information to management and public groups