Transition Unit Supervisor

Berkshire Hathaway Homestate Companies•Sacramento, CA

1d•$80,160 - $114,280

About The Position

The Transition Unit Supervisor is responsible for the acclimation, training, performance, effective operation, and supervision of a training unit of Claims Professionals handling a variety of claims. This role focuses on assuring the efficient application of initial medical claims training as well as managing the transition of team members to indemnity training and claims handling. This position is responsible for the management of a team managing medical-only and non-complex indemnity claims across multiple jurisdictions.

Requirements

High school diploma or equivalent educational certification required
Minimum of two years of relevant experience and training, or an equivalent combination of education and experience
Prior supervisory experience in workers compensation claims management preferred
Credentialed/licensed to adjust workers compensation claims in one or more jurisdictions, one of which is California
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 read, analyze, and interpret business periodicals, professional journals, technical procedures, medical reports, bills, legal briefs, statutes, regulations, and court opinions
Able to write clear, concise reports accurately conveying complex and nuanced information
Ability to write clear, effective correspondence on complex medical and legal points to people from all walks of life
Able to effectively present information and respond to questions with executives, clients, attorneys, and customers, both in individual conversations and presentations to groups
Able to investigate, persuade, and negotiate over the telephone
Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
Able to compute rate, ratio, and percent
Familiar with the time value of money and reducing future streams of payments to a present value
Familiar with the concept of statistical likelihood as the basis for calculating the value of a possible financial outcome
Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
Able to deal with problems involving several concrete variables in standardized situations
Sound knowledge of workers compensation regulations; demonstratable ability to apply them skillfully and consistently
Mastery of Microsoft Office applications and working knowledge of SalesForce
Ability to rapidly master the use of proprietary software applications

Nice To Haves

Bachelor's degree from an accredited college or university preferred

Responsibilities

Ensure team member completion of all medical claims training topics, and effective application of training on the job; support training topics with various resources including one-on-one coaching and practical application exercises in Compass, CXP and Salesforce
Ensure successful transition to and completion of appropriate indemnity training topics, and transition to an indemnity team; identify and recommend appropriate timing of and indemnity team placement
Manage the workflow of the unit including planning, assigning, and directing work; ensure continuing education requirements of the team are met and maintained timely
Ensure the team manages claims in compliance with Company policies, applicable statutes, regulations, regulations and case law across various jurisdictions; monitor claim management and provide direction and intervention as appropriate
Ensure claim reserves and benefit payments are accurate and timely
Manage the team’s efforts to produce successful claim outcomes for providing compassionate care to our recovering workers while achieving high service levels, timely medical management decisioning, prompt claim closures, effective claim cost containment, achievement of goals, and satisfactory claim audits
Successfully implement changes to the laws and regulations governing claims handling and communicate their impact to the processes, tactics, and strategies of claim management
Address policy exceptions, inquiries, escalated issues, and complaints appropriately
Introduce and orient team to internal network of Medical Management, Legal and Subrogation teams, as well as external legal and investigation vendors; facilitate relationship-building
Ensure unit achieves organizational goals via prompt claim closures, high client satisfaction with service, and effective, strategic cost containment
Foster and guide the personal and professional development and growth of individual team members to help them build successful and satisfying careers while producing excellent results
Identify and communicate training needs, assist with facilitating training topics, and support the concepts and techniques taught throughout the training program
Actively reinforce and support Company programs and initiatives regarding strategic and tactical innovation and improvement
Maintain workplace culture of professionalism, collaboration and inclusion, and excellence in service, aligning with our Mission and Shared Values; serve as a role model by embodying the highest standards of performance, behavior, and ethical standards