Now Hiring: Claims Team Lead Apply today because openings are limited!! Overview To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on c[ "\t. Supervises multiple teams of exam... more details
Now Hiring: Claims Team Lead Apply today because openings are limited!! Overview To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on c
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Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
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Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
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Provides technical/jurisdictional direction to examiner reports on claims adjudication.
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Compiles reviews and analyzes management reports and takes appropriate action.
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Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
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Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
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Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
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Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
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Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
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