Claims Supervisor - San Diego

JOB OVERVIEW:

The Claims Supervisor directly reports to the Manager of the Claims Department and is an integral member of the Claims Leadership Team.  The Claims Supervisor is responsible for the analysis and management of claim files within their unit.  Supervision includes: claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, reserve accuracy, effective negotiation and appropriate resolution.  The Claims Supervisor is a mentor to not only the specific unit, but also the entire claim department and is available for consultation/discussion with staff as the primary responsibility.  The Claims Supervisor is responsible for staff training and development.  The Claims Supervisor will work closely with other members of Claims Leadership to insure the efficient and effective resolution of issues.  The Claims Supervisor is charged with managing pending claims, improving file quality and controlling expenses.  The Claims Supervisor will conduct the management of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the WCAB and State of California. The Claims Supervisor is expected to function at a high level of expertise and competency, while consistently exercising good judgment and independent discretion. The Claims Supervisor is expected to support Company goals, Department Goals and advance Company values.

RESPONSIBILITIES:

• Direct management of staff of up to 6 examiners and their claim files
• Manage Loss Costs
• Manage Loss Expenses
• Analyzes file plans
• Approve action plans in accordance with best practices
• Complete 10-day diary reviews on all new losses and maintain active diaries of all claims in the unit
• Document the claim file of all activities taken
• Work with the examiner throughout the life of the claim
• Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
• Frequently communicate with all appropriate parties involved with the claim
• Maintain professional vendor relationships
• Actively execute appropriate claims activities to ensure consistent delivery of quality claims service
• Recommend staff payment and settlement authority for employees in unit
• Compliance with state laws and regulations regarding claim handling
• Shared responsibility for department budget, which includes planning and ongoing management of salary and expenses
• Claim Management as measured through aggressive action plans and overall supervision as measured by reduction in average paid and average age of cases at time of closing
• Other tasks assigned by the Vice President of Claims

MINIMUM REQUIREMENTS:

• 5+ years of successful claim management/leadership experience
• Ability to mentor and motivate subordinate staff
• Strong written and verbal communication skills
• In-depth knowledge of appropriate legal principles
• In-depth knowledge of laws for workers’ compensation
• Strong organizational skills
• Strong negotiation skills
• PC literate
• Bachelor’s degree from an accredited college or university preferred