Workers Compensation Claims Supervisor

Tristar Insurance • Waukesha, WI

1d • $95,000 - $105,000

About The Position

Under minimal supervision, the Workers Compensation Claims Supervisor oversees daily operations of a workers’ compensation claims unit to ensure timely, accurate, high-quality claims handling in compliance with applicable state laws, client requirements, and company policies and procedures. The supervisor provides technical guidance, training, and performance oversight to assigned staff and regularly collaborates with clients, management, Claims Examiners, and other TRISTAR personnel to resolve claims and service issues.

The position supervises examiners and clerical staff, manages caseload and staffing needs, reviews claims and files, makes daily claims decisions, approves reserve changes and payments within guidelines, and monitors team performance. It also supports client reporting and service, audits, training, vendor oversight, and claims coverage during examiner absences or vacancies. The role is full-time, based in Milwaukee–Waukesha, Wisconsin, with a day shift and no travel. The stated salary range is $95,000–$105,000 per year.

Requirements

• Five or more years of related experience, or an equivalent combination of education and experience.
• Strong technical knowledge of multi-state workers’ compensation laws, regulations, and medical terminology.
• Ability to maintain a claims diary system, prioritize work, and meet strict deadlines.
• Strong analytical and problem-solving skills.
• Proficiency in Microsoft Word and Excel.
• Excellent written and verbal communication skills, including the ability to explain technical claims information clearly to claimants, clients, and staff.
• Ability to supervise, coach, and develop employees with varying levels of experience and technical ability.
• Strong interpersonal skills and ability to maintain effective working relationships.
• Ability to manage competing priorities and remain effective under pressure.
• Ability to model a positive, professional attitude to direct reports.
• Ability to respond promptly to client requests and service needs.
• Certifications and/or licenses as required by state regulation.

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.
• Participate in new-hire processes as needed, including interviewing, training, and completing Personnel Action Forms.
• Monitor daily staffing needs, ensure caseload staffing requirements are met, and distribute caseloads equitably among direct reports.
• Review and address scheduled claims issues, including initial and periodic reviews, delays, and denials.
• Perform file reviews to monitor accuracy and compliance with policies and laws, and ensure consistent and accurate claim coding.
• Prepare agendas for and lead team meetings with direct reports.
• Make daily claims decisions involving claim strategies, action plans, payments and recoveries, and carrier or excess reporting.
• Run supervisory reports to monitor performance and assist direct reports.
• Review and approve reserve changes and payments within company and client guidelines.
• Establish supervisory diaries on claim files and complete pending diaries by their due dates.
• Prepare for claim audits, review audit results, and provide appropriate rebuttal feedback.
• Coordinate, conduct, and lead internal and external training sessions on updated laws, policies, and procedures.
• Respond to claimant and vendor concerns and facilitate timely resolution.
• Evaluate vendor effectiveness and modify vendor panels within TRISTAR and account guidelines.
• Ensure staff follow client service instructions and applicable state reporting requirements.
• Provide claims-handling coverage during examiner absences and position vacancies.
• Prepare, evaluate, and analyze monthly client reports.
• Coordinate, facilitate, and support internal and external audits.
• Participate in client file and claim reviews and address action items.
• Partner with the corporate office and sales and service teams on requests for proposals and client service issues.
• Adhere to TRISTAR’s Best Practices.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED