Workers Compensation Claims Team Lead

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

📋 Description

• Oversee various teams of workers' compensation examiners and technical personnel.

• Track colleagues' workloads, training progress, and individual claim activities.

• Offer technical and jurisdictional guidance on claims adjudication reports.

• Maintain claim diaries, including regular updates for complex or high-exposure claims.

• Recognize and inform management about trends, challenges, issues, and recommended actions.

• Notify management of new procedures and continuous improvement suggestions.

• Coordinate office projects alongside management.

• Gather, review, and analyze management reports and take necessary actions.

• Conduct quality reviews on claims to adhere to audit, service contract, and quality standards.

• Serve as a second-level appeal for client and claimant concerns and implement final resolutions.

• Assess reserves on high-cost claims and those exceeding examiner authority.

• Supervise third-party, litigated, serious vocational rehabilitation, questionable, and sensitive claims.

• Maintain communication with clients, recommend actions based on claim status, and provide written claim summaries.

• Ensure that direct reports are properly licensed in the jurisdictions served.

• Confirm that claim files are accurately coded and sufficiently documented.

• Enforce personnel policies and adhere to staffing and training recommendations.

• Conduct interviews, hire candidates, develop performance plans, and hold performance discussions.

• Offer support, guidance, leadership, and motivation to foster maximum performance.

⛳️ Requirements

• Minimum of 5 years of experience in Workers' Compensation claims management or an equivalent combination of education and experience is required.

• High School Diploma or GED is mandatory.

• Supervisory experience is preferred.

• A Bachelor's degree from an accredited college or university is preferred.

• Professional certification relevant to the line of business is preferred.

• Knowledge of jurisdictional regulations: FL, GA, IN, KY, NC, SC, TN, VA.

• Direct reports must hold appropriate licenses in the jurisdictions serviced.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunity to work in an agile environment.

• Career development and promotional growth opportunities.

• Medical, dental, and vision benefits available from day one.

• 401K plan with matching contributions from day one.

• Paid Time Off (PTO).

• Disability and life insurance coverage.

• Employee assistance program.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.

• Emphasis on work-life balance.

• Opportunities for professional development.