Worker's Compensation Claims Supervisor

Tristar Insurance•Rancho Cordova, CA

6d•$100,000 - $110,000•Onsite

About The Position

Under minimal supervision, the Worker's Compensation Claims Supervisor manages and directs a dedicated claims unit to ensure quality results and compliance with applicable state laws and company and client procedures. The role involves considerable interaction with the client, management, Claims Examiners, and other TRISTAR staff. Consistent office attendance, punctuality, and professional communication are essential for continuity of operations during the leave coverage period. The supervisor directly supervises Claims Examiners and Claims Assistants and may oversee File/Mail Clerks and Administrative Assistants as needed. The position requires knowledge of California statutory regulations and claims procedures, sound analytical and communication skills, and the ability to manage employees with varied skill levels. The role is based in Sacramento – Rancho Cordova, California, and is listed as full-time, day shift.

Requirements

Three to five years of related experience, or an equivalent combination of education and experience.
Technical knowledge of statutory regulations, including rules and procedures relating to California.
Ability to work on a diary system, prioritize tasks, and meet strict deadlines.
Strong analytical skills.
Proficiency in Microsoft Word and Excel.
Excellent written and verbal communication skills, including the ability to convey technical details to claimants, clients, and staff.
Ability to manage employees with various skill levels.
Excellent interpersonal skills.
Certifications and/or licenses as required by state regulation.
Bachelor’s degree in a related field preferred.

Nice To Haves

Bachelor’s degree in a related field.

Responsibilities

Directly supervise examiners and clerical staff, including monitoring attendance and job performance, conducting evaluations, and addressing disciplinary issues.
Review and address scheduled claims issues, including initial and periodic reviews, delays, and denials.
Review and approve reserve changes, awards, and payments within company and client guidelines.
Perform claim file reviews to monitor compliance with policies and laws.
Establish appropriate supervisory diaries on claim files and complete pending diaries by their scheduled due dates.
Prepare for claim audits, review audit results, and provide appropriate rebuttal feedback.
Coordinate and lead staff training on updated laws, policies, and procedures.
Ensure daily caseload staffing requirements are met.
Respond to claimant and vendor concerns and issues as needed.
Ensure client service instructions are followed.
Analyze monthly client reports.
Facilitate internal and external audits.
Attend client file-staffing meetings in person or by telephone.
Perform other duties as assigned.