FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
About the role
Key responsibilities & impact- Supervise multiple teams of examiners, multiple product line examiners, and/or at least seven technical operations colleagues
- Monitor colleagues' workloads and individual claim activities
- Provide training and technical/jurisdictional direction on claims adjudication reports
- Identify and advise management of trends, problems, issues, and recommended actions
- Inform management of new procedures and continuous process improvement ideas
- Coordinate projects with management
- Compile, review, and analyze management reports and take appropriate action
- Support the organization's quality programs
- Administer company personnel policies and follow staffing standards and training recommendations
- Interview, hire, and establish colleague performance development plans
- Conduct performance discussions and provide leadership, guidance, support, and motivation
- Perform quality reviews on claims in compliance with audit, service contract, and quality standards
- Act as second-level appeal for client and claimant issues and implement final dispositions
- Review reserve amounts on high-cost claims and claims exceeding examiner authority
- Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, promote professional client relationships, make claim-status recommendations, and provide written claim resumes
- Ensure claims files are correctly coded and adequately documented
- Maintain diaries on team claims, including frequent diaries on complex or high-exposure claims
Requirements
What you’ll need- High School Diploma or GED required
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- Six (6) years of claims experience or equivalent combination of education and experience required
- Two (2) years of claims supervisor experience
- All 50 states & Home State or Reciprocal licensing required
- Direct reports must be properly licensed in the jurisdictions serviced
- Ability to think clearly and conceptually
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress and multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding
- Travel as required
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Medical, dental, and vision coverage on day one
- 401K on day one
- 401K matching
- Paid time off (PTO)
- Disability and life insurance
- Employee assistance program
- Flexible spending or health savings account
- Other additional voluntary benefits
- Reasonable accommodations when applicable and appropriate