Title: Claims Supervisor Workers Compensation-Remote-CA- CA SIP (38522)

Term: Direct Hire

Salary: $110,000-$115,000 DOE

Location: Remote (California)

Claims Supervisor - Direct Hire - Full Time - Remote CA - SIP CERTIFIED - Salary Range $110,000-$115,000 DOE

This position is required to have 4850 code experience. This is required for Police and Fire Department workers compensation claims.

POSITIONS SUPERVISED: Directly: Claims Examiners and Claims Assistants - 10 years of experience required

POSITION SUMMARY: Under minimal supervision, manages and directs activity of a Self-Insured claims unit ensuring high-quality results and management of claims in compliance with state laws and company/client procedures. This position requires considerable interaction with the client, management, other Claims Examiners, and other staff in the office; therefore, consistently being at work in the office, in a timely manner, is inherently required of this position.

DUTIES AND RESPONSIBILITIES:

• Directly supervises examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues.
• Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.
• Reviews and approves reserve changes, awards, and payments within Company and Client guidelines.
• Performs file reviews to monitor compliance with policies and laws.
• Establishes appropriate supervisory diaries on claim files and completes pending diaries on or before scheduled due dates.
• Prepares for claim audits, reviews audit results, and provides appropriate rebuttal feedback.
• Coordinates and leads training sessions for staff on updated laws, policies, and procedures.
• Ensures daily caseload staffing requirements are met.
• Responds to claimant and vendor concerns and issues as needed.
• Ensures client servicing instructions are being adhered to.
• Analyzes monthly client reports.
• Facilitates internal and external audits.
• Attends client file-staffing meetings in-person or telephonically.
• Other duties as assigned including supervision of other jurisdictions as needed.

*Essential job function.

EQUIPMENT OPERATED/USED: Computer, 10-key, printer, copier, fax machine and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire.

QUALIFICATIONS REQUIRED:

Education/Experience: Bachelor’s degree in related field (preferred); 10 (ten) years related experience; or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

• Technical knowledge of statutory regulations.
• Ability to work on a diary system, prioritize tasks and meet strict deadlines.
• Strong analytical skills.
• Proficient in Word and Excel.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
• Ability to manage employees of various skill levels.
• Excellent interpersonal skills.

Other Qualifications:

• Certifications and/or licenses as required by State regulation.

This can be in office or remote. They do not need to live in Fresno, but they must have a CA SIP (Self-insured license) to be able to handle the Workers Compensation claims in California.

Job Type: Full-time

Pay: $110,000.00 - $115,000.00 per year

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• 4850 code: 1 year (Required)
• Workers' compensation claims: 10 years (Required)

License/Certification:

• (California) CA SIP (Self-insured license) (Required)

Work Location: Remote

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