8165-Worker's Compensation Supervisor I
About The Position
Under general direction, the Worker's Compensation Supervisor assists and provides first-line oversight of claims adjusting and processing teams for the Workers' Compensation Division. Performs complex work in supervising the review, analysis, investigation and disposition of workers' compensation claims and reports. Provides claims supervision of confidential complex cases; provides technical training, auditing, and supervising of personnel; serves as the departmental liaison to client departments regarding activities of the assigned workers' compensation program; works with the City Attorney's office on litigation strategies; and performs other related duties as required.
Requirements
- Four (4) years of verifiable experience adjusting workers' compensation claims; AND
- Possession of a Self-Insured Administrator's Certificate issued by the State of California, Department of Industrial Relations.
Responsibilities
- Receives and reviews all incoming workers' compensation claims to determine complexity and assign to appropriate claims adjusting staff.
- Advises claims adjuster, claims assistants, and support staff on appropriate claims handling techniques.
- Provides claims supervision of catastrophic cases, death cases, and confidential complex cases.
- Serves as the liaison for the workers' compensation coordinators of the client departments.
- Serves as the workers' compensation technical expert to advise staff and client departments on changes and applicability of workers' compensation laws.
- Audits the work product of claims adjusters to ensure compliance with applicable laws, and departmental best practices.
- Generates statistical reports and completes analysis of data.
- Works with the City Attorney's office on litigation strategies for complex claims.
- Reviews all self-imposed penalties to determine liability and authorizes payment.
- Authorizes medical treatment for complex medical cases.
- Reviews the assignment of Medical Legal Evaluators (which include Agreed, Qualified, and/or Independent Medical Evaluators) on complex cases.
- Works collaboratively with the Occupational Nurse Consultant, Nurse Manager, and/or Nurse Case Managers to review complex claims and establish medical protocols.
- Advises the Occupational Nurse Manager and/or Consultant on issues related to medical clinic operations.
- Provides ongoing system support to claims staff.
- Accurately estimates the potential claim costs (reserves) on complex cases.
- Provides technical assistance to claims adjusters in determining permanent disability award calculations.
- Directs the claims investigation on complex claims.
- Reviews and approves negotiated case settlement/s with injured workers, attorneys, and interested parties based on established authority levels.
- Provides daily supervision, guidance, coaching, and mentoring to assigned staff.
- Completes ongoing performance evaluations of all assigned staff.
- Provides specialized technical training, as needed, to staff.
- Performs related duties and responsibilities as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
