Claims Supervisor - Workers' Comp

Athens Administrators•Orange, CA

1d•Hybrid

About The Position

Athens Administrators is hiring a Claims Supervisor to support its California Workers’ Compensation department. The role leads claims operations and collaborates with management to meet company goals, improve processes, make claims decisions, review files, approve payments and reserve increases above examiner authority, and ensure accurate coding, quality file handling, and unit closing goals. The supervisor plans and delegates workloads, oversees staff activities, provides coaching and training, and supports hiring and onboarding. The position also manages client relationships and policy or claims issues, attends meetings, ensures compliance with client instructions and best practices, and documents interactions. The supervisor directly oversees 6–10 claims staff and handles related fiscal and timekeeping responsibilities. Employees who live within 36 miles of the Concord or Orange, California office and have a direct report in the office are required to work onsite once a week. Remaining days may be worked remotely if technical requirements are met and the employee resides in California. Athens offices are open Monday through Friday, 7:30 a.m. to 5:30 p.m.; employees may work a flexible schedule with every third Monday or Friday off. The role also requires attending an onsite Leadership Summit at Athens’ Concord headquarters every 18 months, including overnight travel.

Requirements

High school diploma or GED required.
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; if not already obtained, it must be earned within one year of employment.
Completion of IEA or equivalent courses.
At least 3 years of recent, high-level California workers’ compensation claims handling experience.
At least 2 years of claims supervisory experience.
In-depth knowledge of California workers’ compensation laws, policies, and procedures.
Proficiency in determining case value, reserving, and negotiating settlements.
Understanding of medical and legal terminology.
Proficiency in Microsoft Office Suite and ability to learn additional systems; the posting gives ClaimsXpress as an example.
Ability to create reports using standard tools or custom document formats and to plan, prioritize, and organize a unit’s claims workload.
Ability to lead by example, delegate effectively, and ensure timely task completion under stress and tight deadlines.
Demonstrated ability to influence, coach, and motivate staff toward unit and organizational goals.
Strong organizational and time-management skills; flexibility, adaptability, a positive approach, and alignment with Athens values.
Ability to develop and maintain effective working relationships with coworkers, clients, vendors, and other stakeholders.
Strong analytical, reasoning, and problem-solving skills; ability to interpret information from multiple sources and make informed recommendations using independent judgment.
Strong mathematical calculation skills and high accuracy.
Highly developed written and verbal communication skills, presentation skills for small and large groups, attention to detail, and tactful negotiation skills.
Ability to appropriately handle confidential, proprietary, and highly sensitive information and demonstrate honesty, integrity, care, and respect.
Ability to embrace the leadership role and help senior management achieve goals using innovative strategies and a strong commitment to service and results.
Valid driver’s license and ability to travel, including for in-office file reviews and meetings.
Ability to type quickly and accurately for sustained periods.

Nice To Haves

Associate or bachelor’s degree preferred.
At least 5 years’ experience in a workers’ compensation lead or supervisor position preferred.
Prior Third-Party Administrator (TPA) experience preferred.

Responsibilities

Collaborate with Athens management to achieve company initiatives and performance goals, and improve or streamline processes.
Authorize payments and settlements; make daily claims decisions; review claim files; and approve payments and reserve increases above examiner authority.
Run reports accurately and confidentially, and ensure claims coding, file handling, analysis, reserves, and resolutions meet quality standards and unit closing goals.
Work with internal and client senior management and attorneys on settlements and litigation strategies; communicate with clients, attorneys, doctors, investigators, and injured workers.
Discuss the appropriateness of medical treatment with medical case managers and adapt to demanding or changing situations.
Plan, organize, and delegate workload; supervise daily team activities; monitor progress and policy compliance; and address issues or conflicts.
Identify, coordinate, provide, and participate in staff coaching and training; interview, onboard, and train new hires.
Guide employees, support professional development, review performance, set goals, provide feedback, address disciplinary or workflow problems, and document employee relations issues in coordination with Human Resources.
Lead staff meetings for remote and onsite employees and foster open communication.
Address client issues involving policies, programs, and claims; maintain relationships through accessibility and regular service calls; and proactively identify and resolve potential problems.
Attend client, internal, and workers’ compensation meetings, both virtual and in person; ensure diaries and notepads meet client instructions and Athens best practices; and document meeting notes in shared locations.
Ensure audit results meet or exceed Athens and client standards and act in the client’s best interest.
Supervise, schedule, assign, monitor, and evaluate the work of 6–10 assigned employees.
Review and approve direct reports’ monthly expense reports and timecards; manage expenses responsibly; identify cost improvements; and understand applicable wage and hour laws.
Travel for in-office file reviews and meetings and attend the onsite Leadership Summit at the Concord headquarters every 18 months, including overnight travel.