Medical Only Claims Team Supervisor

Ccmsi • Lisle, IL

5d • Hybrid

About The Position

CCMSI is seeking a Medical Only Claims Team Supervisor to join the Illinois Public Risk Fund, the largest Public Entity Workers’ Compensation pool in the State of Illinois. This role is responsible for the investigation, adjustment, and supervision of assigned medical only claims (workers' compensation claims). It can serve as an advanced training position for promotion to higher management roles. The position is accountable for the quality of claim services and focuses on workers' compensation claims and training of medical only and clerk employees, with an emphasis on growth and promotions. Daily support is provided to Medical Only Claims Advocates (adjusters) and Administrative Support staff.

Requirements

• 5+ years claim handling experience is required.
• Excellent oral and written communication skills.
• Initiative to set and achieve performance goals.
• Good analytic and negotiation skills.
• Ability to cope with job pressures in a constantly changing environment.
• Knowledge of all lower level claim position responsibilities.
• Must be detail oriented and a self-starter with strong organizational abilities.
• Ability to coordinate and prioritize required.
• Flexibility, accuracy, initiative and the ability to work with minimum supervision.
• Discretion and confidentiality required.
• Reliable, predictable attendance within client service hours for the performance of this position.
• Responsive to internal and external client needs.
• Proficient with Microsoft Office programs

Nice To Haves

• Bachelor’s Degree is preferred.
• Three years supervisory experience preferred.
• Team lead experience will be considered.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
• AIC Preferred

Responsibilities

• Review, assign and provide supervision of all claim activity (workers' comp and med only) for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.
• Train and lead a team of Medical Only Claim Adjusters.
• Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.
• Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
• Provide oversight of medical, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Supervision of all claim activity for specified accounts.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
• Sort daily mail; remove priority mail and checks for immediate action.
• Process incoming checks.
• Work with Treasury funding and Treasury check printing.
• Performance appraisals and objective/goal setting and attainment of claim and support staff.
• Conduct monthly check audit.

Benefits

• 4 weeks ( Paid time off that accrues throughout the year in accordance with company policy)
• 10 paid holidays in your first year
• Medical, Dental, Vision, Life, and Disability Insurance
• 401(k) and Employee Stock Ownership Plan (ESOP)
• Internal training and advancement opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level