Claims Team Lead - Workers Compensation
Insurance Placement Solutions has an immediate opening for a Workers Compensation Claims Team Lead with our client in the Rancho Cucamonga, CA area. As a member of our client’s claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer and resolve claims in a timely manner in accordance with legal statutes, policy provisions, and company guidelines.
Workers Compensation Claims Team Lead Responsibilities
- Supervises multiple teams of examiners, single of 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.
- Identifies and advises management of trends, problems, and issues as well as a recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
- Provides technical/jurisdictional direction to examiner reports on claims adjudication.
- Compiles reviews and analyzes management reports and takes appropriate action.
- Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
- Acts as the second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
- Reviews reserve amounts on high-cost claims and claims over the authority of the individual examiner.
- Monitors third-party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
- 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 the client.
- Assures that direct reports are properly licensed in the jurisdictions serviced.
- Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
- 6+ years of experience handling workers compensation lost-time/indemnity claims as a workers compensation claims adjuster or claims team lead
- SIP required
- High school diploma or equivalent
- Bachelor's degree from an accredited college or university preferred
About Insurance Placement Solutions
IPS is an insurance staffing and recruiting firm dedicated to the insurance industry, including workers' compensation claims jobs in the Rancho Cucamonga, CA area. Our services are designed to be a resource for clients to gain access to high-caliber talent. Many of our clients do not have the dedicated manpower to quickly fill their temporary, temporary to hire, or direct hire vacancies. That is where we come in. Our clients are able to utilize our services to maintain business-as-usual during unforeseen interruptions and fluctuating business needs. Plus, our candidates benefit from gaining backdoor access to highly sought-after positions with top companies in the industry.
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