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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims supervision, including training and directing teams, managing complex claims, and ensuring compliance with quality standards. Possesses strong analytical skills to identify trends and recommend process improvements while maintaining professional client relationships.
Highest-signal resume keywords
Claims SupervisionClaims AdjudicationQuality ReviewJurisdiction KnowledgePerformance Development
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ExperienceClaims ManagementClaims CodingPerformance EvaluationProcess ImprovementData AnalysisReport CompilationTraining and DevelopmentLicensing ComplianceWorkload Monitoring
Soft Skills
LeadershipProblem SolvingJudgmentCommunicationStress Management
Certifications & Qualifications
Professional CertificationHome State Licensing
Industry Keywords
Workers CompensationClaims ExaminerHigh-Exposure ClaimsThird-Party ClaimsVocational RehabilitationAudit ComplianceService Contract StandardsClient Relationship ManagementPerformance StandardsJurisdiction Knowledge
About the role
Key responsibilities & impact- Supervise multiple teams of workers compensation examiners and technical staff
- Monitor colleagues' workloads and individual claim activities
- Provide training and technical/jurisdictional direction on claims adjudication
- Maintain claim diaries, including frequent diaries on complex or high-exposure claims
- Identify and advise management of trends, problems, issues, and recommended actions
- Inform management of new procedures and continuous process improvement ideas
- Coordinate office projects with management
- Compile, review, and analyze management reports and take appropriate action
- Perform quality reviews on claims in compliance with audit, service contract, and quality standards
- Act as second level of 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 review litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, promote professional client relationships, and make claim recommendations
- Provide written claim resumes to clients as requested
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure claims files are correctly coded and adequately documented
- Administer personnel policies and follow staffing and training standards
- Interview, hire, establish performance development plans, and conduct performance discussions
- Provide guidance, leadership, motivation, and support to maximize performance
- Support the organization's quality programs
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
- Home state licensing required
- Jurisdiction knowledge: IL, MN, MI, WI, IA, IN
- Ability to supervise multiple teams of examiners and technical staff
- Ability to handle multiple priorities and meet deadlines
- Clear and conceptual thinking ability
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress
- Computer keyboarding ability
- Hearing, vision, and talking abilities
- Ability to travel as required
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities
- Medical, dental, and vision benefits on day one
- 401K and matching on day one
- Paid time off (PTO)
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
- Hybrid work arrangement with three days working from home and two days in the office each week