Workers Compensation Claims Supervisor

Candidate selected to fill this position must live within the state of Georgia. The employee’s telecommuting work site location will contain a designated and approved workspace at the employee’s home address.

Position Responsibilities

• Provide and model outstanding customer service, teamwork, and organizational commitment; Support the overall organization by executing the directives as set forth by the Executive Director or their designee;

Claims Administration and Operation Management

• Supervise the day-to-day operations of the Association's workers' compensation unit; Review files that are assigned to examiners; Review and approve reserves and payments for claims;

• Evaluate insurance claims filed through ACCG Insurance Division programs to determine claim type and provide initial instructions to claims examiners;
• Review and reconcile deductible billing process and errors; review Electronic Data Interchange (EDI) submission and error resolution for state filings; Review and approve a variety of unit status reports, settlement authority requests, excess reports, denied claims, pre-trial reports, vendor usage, payments and reserves;
• Receive and respond to inquiries and requests for information from members, injured employees, vendors, case managers, legal representatives, and medical providers;
• Review lawsuits for coverage; determine coverage exclusions that may apply; Review closed claim files; complete claim file audits prepare summaries of claims pending for Association members as requested;
• Occasional overnight travel required, less than 15 days per year (i.e. LGRMS led training sessions).

Training and Supervision

• Coach and develop assigned personnel skill sets; Assign and direct work tasks and evaluate the performance of assigned personnel;
• Assist in the recruitment and selection of assigned personnel;

Knowledge, Skills and Abilities

Incumbent possesses:

• Thorough knowledge of the laws, legal codes, court procedures, precedents, programs and policies, as well as government regulations and agency rules that impact and guide the work of the Insurance Division;
• Proven ability to successfully mentor, direct, and interpret information for the benefit and development of supervisees;
• Thorough knowledge of the principles, practices, and process of insurance liability claims handling and administration, workers' compensation system requirements, and medical only claim administration;
• Ability to establish and maintain effective working relationships with associates, claimants, attorneys, Nurse Case Managers, physicians, local government officials, customers, and the general public.
• Thorough knowledge of standard office practices, procedures, equipment, and administrative support techniques; ability to operate a variety of standard office equipment including personal computer and associated software; ability to type accurately at a reasonable rate of speed.
• Thorough knowledge and execution of business English, spelling and arithmetic, and the ability to communicate ideas effectively in both oral and written formats;

Education and Experience

• Bachelor's degree with coursework in business administration, insurance, or related field preferred; and
• extensive (typically 10-15 years) experience of an increasingly responsible nature in workers' compensation claims handling and administration, including moderate supervisory experience; or
• Equivalent combination of education and experience.

Special Requirements

• Valid driver's license in the State of Georgia