Workers Compensation Claims Supervisor (Hybrid or Remote)

Tristar Insurance•Concord, CA

2d•$108,000 - $112,000•Hybrid

About The Position

Under minimal supervision, manages and directs the activity of a Self-Insured claims unit, ensuring high-quality results and management of claims in compliance with state laws and company/client procedures. This position requires considerable interaction with the client, management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work in the office in a timely manner is inherent to this position.

Requirements

Bachelor’s degree in related field (preferred); 5 (five) + years related experience; or equivalent combination of education and experience.
Technical knowledge of statutory regulations.
Ability to work on a diary system, prioritize tasks, and meet strict deadlines.
Strong analytical skills.
Proficient in 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 of various skill levels.
Excellent interpersonal skills.
Certifications and/or licenses as required by State regulation.

Responsibilities

Directly supervise examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues.
Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.
Reviews and approves reserve changes, awards, and payments within Company and Client guidelines.
Performs file reviews to monitor compliance with policies and laws.
Establishes appropriate supervisory diaries on claim files and completes pending diaries on or before scheduled due dates.
Prepares for claim audits, reviews audit results, and provides appropriate rebuttal feedback.
Coordinates and leads training sessions for staff on updated laws, policies, and procedures.
Ensures daily caseload staffing requirements are met.
Responds to claimant and vendor concerns and issues as needed.
Ensures client servicing instructions are being adhered to.
Analyzes monthly client reports.
Facilitates internal and external audits.
Coordinate and attend client file reviews and staffing meetings in-person or telephonically.
Other duties as assigned, including supervision of other jurisdictions as needed.
Essential job function.