Team Lead, Claims – Workers Compensation

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead a team of Adjusters and Specialists.

• Oversee workloads and provide supervisory guidance for individual claim activities.

• Offer technical and jurisdictional guidance on claims adjudication.

• Review and authorize claim denials, payments, settlements, trials, and reserve requests.

• Conduct claim audits to ensure compliance with statutory/regulatory requirements, internal procedures, guidelines, and quality standards.

• Ensure reserves are appropriately established for potential claim outcomes.

• Perform leader reviews and provide feedback and recommendations on claim files.

• Address escalated complaints and concerns from agents, brokers, and policyholders.

• Identify problematic trends and create corrective measures.

• Undertake additional projects as directed by management.

• Ensure the quality, accuracy, and prompt resolution of claims, including high-exposure and complex cases.

• Advocate for departmental goals and objectives.

• Monitor workflows, claims processes, metrics, triage, and caseloads.

• Foster and promote excellence in customer service.

• Recruit and develop adjusters while identifying opportunities for skill enhancement.

• Collaborate directly with the Claims Manager to meet team and departmental objectives.

⛳️ Requirements

• Minimum of 2 years in adjusting claims at a senior level.

• Experience with California workers’ compensation claims is mandatory.

• Additional experience in AZ, NM, NV, OR, or UT is advantageous.

• Extensive knowledge of workers' compensation across multiple states, general insurance policy coverage, and state case laws.

• Exceptional written, verbal, and presentation communication skills.

• Advanced problem-solving abilities for intricate situations.

• Intermediate understanding of personal tasks and their impact on team dynamics and deliverables.

• Strong leadership skills aimed at fostering growth and development in direct reports.

• Proficient in G-Suite tools, collaboration platforms, and Microsoft Office Suite.

• High School diploma or GED is required.

• Bachelor’s Degree is preferred.

• Must reside and work in the United States, excluding territories.

• Access to reliable, high-speed internet is essential.

🏝️ Benefits

• Competitive cash compensation.

• Comprehensive health plans.

• Generous PTO.

• Future-focused 401k match.

• Generous parental and caregiver leave.

• Discretionary bonuses may be awarded to eligible team members based on company performance.