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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, providing technical direction on claims adjudication, and maintaining compliance with jurisdictional requirements. Proven ability to lead teams, analyze claims data, and implement process improvements for enhanced operational efficiency.
Highest-signal resume keywords
Claims Supervision ExperienceTechnical Direction on Claims AdjudicationNV Licensing/Jurisdiction KnowledgeClaims Analysis and ReportingProcess Improvement Implementation
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 AdjudicationQuality Compliance ReviewClaims CodingManagement ReportingPerformance Development PlansTroubleshootingProblem SolvingAnalysisComputer Keyboarding
Soft Skills
Clear Thinking AbilityExcellent JudgmentDiscretionAbility to Handle Work-Related StressAbility to Meet Deadlines
Certifications & Qualifications
Professional Certification in Line of Business
Industry Keywords
Workers CompensationClaims ManagementClaims ExaminerHigh-Exposure ClaimsClient RelationshipsPerformance DiscussionsContinuous Process ImprovementTechnical Operations
About the role
Key responsibilities & impact- Supervise multiple teams of workers compensation examiners and technical staff
- Monitor colleagues' workloads, provide training, and monitor individual claim activities
- Provide technical and jurisdictional direction on examiner reports and claims adjudication
- Maintain claim diaries, including frequent diaries on complex or high-exposure claims
- Identify trends, problems, and issues and advise management on recommended actions
- Inform management of procedures and ideas for continuous process improvement
- Coordinate office projects with management
- Compile, review, and analyze management reports and take appropriate action
- Perform quality reviews on claims for audit, service contract, and quality compliance
- Act as second-level appeal authority for client and claimant issues and implement final dispositions
- Review reserve amounts on high-cost claims and claims exceeding examiner authority
- Monitor third-party, litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, promote professional client relationships, and provide claim recommendations and written claim resumes
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure claims files are correctly coded and adequately documented
- Administer personnel policies, interview and hire colleagues, establish performance development plans, and conduct performance discussions
- Provide support, guidance, leadership, and motivation
- Support organizational quality programs
- Perform other duties as assigned
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 claims supervisor experience required
- NV licensing/jurisdiction knowledge required
- Ability to provide technical/jurisdictional direction on claims adjudication
- Ability to supervise multiple teams and several (minimum seven) technical operations colleagues
- Clear and conceptual thinking ability
- 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 benefits on day one
- 401K on day one
- Reasonable accommodations when applicable and appropriate