Claims Team Lead

1 week ago

Santa Barbara, United States Insurance Placement Solutions Full time

Insurance Placement Solutions has an immediate opening for a Workers' Compensation Claims Team Lead with our client in the California area. As a member of our client’s claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer and resolve claims in a timely manner in accordance with legal statutes, policy provisions, and company guidelines.

Workers Compensation Claims Team Lead Responsibilities

  • Supervises multiple teams of examiners, single or multiple product line examiners, and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
  • Identifies and advises management of trends, problems, and issues as well as a recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
  • Provides technical/jurisdictional direction to examiner reports on claims adjudication.
  • Compiles, reviews, and analyzes management reports and takes appropriate action.
  • Performs quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards.
  • Acts as the second level of appeal for client and claimant issues regarding claim-specific, procedural, or special requests; implements final disposition of the appeal.
  • Reviews reserve amounts on high-cost claims and claims over the authority of the individual examiner.
  • Monitors third-party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as determined by the client.
  • Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to the client as suggested by the claim status; and provides written resumes of specific claims as requested by the client.
  • Assures that direct reports are properly licensed in the jurisdictions serviced.
  • Ensures claims files are coded correctly, and adequate documentation is made by claims examiners.

Experience

  • 6+ years of experience handling workers' compensation lost-time/indemnity claims as a workers compensation claims adjuster
  • 2+ years of experience in a supervisory or team lead role
  • Must have California claims handling experience

Certifications

  • SIP Certification

Education

  • A high school diploma or equivalent is required

About Insurance Placement Solutions

IPS is an insurance staffing and recruiting firm dedicated to the insurance industry, including workers' compensation claims jobs in the Los Angeles, CA area. Our services are designed to be a resource for clients to gain access to high-caliber talent. Many of our clients do not have the dedicated manpower to quickly fill their temporary, temporary-to-hire, or direct hire vacancies. That is where we come in. Our clients are able to utilize our services to maintain business as usual during unforeseen interruptions and fluctuating business needs. Plus, our candidates benefit from gaining backdoor access to highly sought-after positions with top companies in the industry.

  • Claims Team Lead

    1 week ago

    Santa Barbara, California, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Workers' Compensation Claims Team Lead with our client in the California area. As a member of our client's claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate, and resolve assigned claims in order to achieve appropriate outcomes. In this position, you...

  • Peer Support Team Lead

    1 week ago

    Santa Barbara, United States Xelerate Full time

    Xelerate is looking for **Peer Support Team Leads **to work for a leader in the Mental Health Field at a new Housing Assistance and Retention Program for Santa Barbara County! Seeking a fresh career opportunity? Passionate about making a difference? Harness your life experiences to empower others! **Overview** - Lead and support a team of Peer Coaches in...

  • TSIB National Director of Claims

    21 hours ago

    Santa Ana, United States Turner Construction Full time

    Division: Turner Surety & Insurance BrokerageProject Location(s): Saddle Brook, NJ 07663 USAMinimum Years Experience: 10 Travel Involved: 10-20% Job Type: Regular Job Classification: Experienced Education: Bachelors Degree Job Family: Insurance and Claims Compensation: Salaried ExemptTSIB is seeking a National Director of Claims. The candidate should possess...

  • TSIB National Director of Claims

    2 weeks ago

    Santa Ana, United States Turner Construction Full time

    Division: Turner Surety & Insurance Brokerage Project Location(s): Saddle Brook, NJ 07663 USA Minimum Years Experience: 10 Travel Involved: 10-20% Job Type: Regular Job Classification: Experienced Education: Bachelors Degree Job Family: Insurance and Claims Compensation: Salaried Exempt TSIB is seeking a National Director of Claims. The candidate should...

  • TSIB National Director of Claims

    1 week ago

    Santa Ana, United States Turner Construction Full time

    Division: Turner Surety & Insurance Brokerage Project Location(s): Saddle Brook, NJ 07663 USA Minimum Years Experience: 10 Travel Involved: 10-20% Job Type: Regular Job Classification: Experienced Education: Bachelors Degree Job Family: Insurance and Claims Compensation: Salaried Exempt TSIB is seeking a National Director of Claims. The candidate should...

  • Team Lead- Home Service Professional

    3 months ago

    Santa Barbara, United States Molly Maid Full time

    Promotion Team Lead

  • Claims Specialist

    6 hours ago

    Santa Ana, United States Illumination Foundation Full time

    “Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

  • Claims Reviewer

    4 weeks ago

    Santa Fe, United States The Workforce Group Full time

    Job DescriptionJob DescriptionSummary:The Claims Reviewer will provide technical in support to the FEMA Hermit's Peak/Calf Canyon Claims Office in Sante Fe, New Mexico. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the Hermit's Peak/Calf Canyon fires. With 325,340 acres burned...

  • Claims Reviewer

    2 weeks ago

    Santa Fe, New Mexico, United States The Workforce Group Full time

    Job DescriptionJob DescriptionSummary:The Claims Reviewer will provide technical in support to the FEMA Hermit's Peak/Calf Canyon Claims Office in Sante Fe, New Mexico. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the Hermit's Peak/Calf Canyon fires. With 325,340 acres burned and 900...

  • Products Representative

    2 weeks ago

    Santa Barbara, United States Kait Hamilton - State Farm Agent Full time

    Position Overview Do you have aspirations to run your own business? If so, you may want to consider working in the office of Kait Hamilton Insurance Agency Inc. As a member of our agency team, you have an opportunity to experience first-hand what it takes to be a State Farm Agent. You will build and develop customer relationships within the community to...

  • Claims Specialist

    4 weeks ago

    Santa Ana, United States Illumination Foundation Full time

    "Every person deserves compassion, dignity, and the safety of a place to call home." Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

  • Claims Specialist

    3 days ago

    Santa Ana, United States Illumination Foundation Full time

    Every person deserves compassion, dignity, and the safety of a place to call home. Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

  • Claims Specialist

    4 weeks ago

    Santa Ana, United States Illumination Foundation Full time

    Job DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...

  • Housing Disability Advocate Lead

    3 weeks ago

    Santa Barbara, United States Good Samaritan Shelter Full time

    Essential Duties and Responsibilities: The HDAP Lead Care Coordinator will provide ongoing case management and support to clients in the HDAP program while also providing day-to-day assistance to the HDAP team. Reporting to the Program Manager, they will work to empower clients and provide guidance to staff in providing case management with a...

  • Health Plan Nurse Coordinator Iii

    1 week ago

    Santa Barbara, United States CenCal Health Full time

    **Salary Range**: $101,007 - $151,510 **Job Summary** The Health Plan Nurse Coordinator III Lead (HPNC III Lead) is a Registered Nurse assigned to the Enhanced Care Management (ECM) operational unit. The HPNC III Lead performs utilization management activities, telephonic or onsite clinical reviews, care coordination, and transitional care services. This...

  • Products Representative

    2 weeks ago

    Santa Barbara, United States Kait Hamilton - State Farm Agent Full time

    Job DescriptionJob DescriptionPosition OverviewDo you have aspirations to run your own business? If so, you may want to consider working in the office of Kait Hamilton Insurance Agency Inc. As a member of our agency team, you have an opportunity to experience first-hand what it takes to be a State Farm Agent. You will build and develop customer relationships...

  • Insurance Claims Clerk

    4 weeks ago

    Santa Ana, United States Kelly Services Full time

    Job DescriptionJob DescriptionKelly Services is looking for a Claims Clerk. Job Opportunity: Claims ProcessorTustin,CaLocation:$24 per hourSalary:Please confirm interest today today! Are you detail-oriented, organized, and proficient with computer systems? We are currently seeking a dedicated individual to join our team as a Claims Processor. In this role,...

  • Products Representative

    4 weeks ago

    Santa Barbara, United States Kait Hamilton - State Farm Agent Full time

    Job DescriptionJob DescriptionPosition OverviewDo you have aspirations to run your own business? If so, you may want to consider working in the office of Kait Hamilton Insurance Agency Inc. As a member of our agency team, you have an opportunity to experience first-hand what it takes to be a State Farm Agent. You will build and develop customer relationships...

  • Logistics Coordinator

    4 weeks ago

    Santa Ana, United States Intelliswift Software Inc Full time

    Logistics Coordinator - Claims and Insurance Job ID: 23-02862 Logistics Coordinator - Claims and Insurance Logistics Coordinator - Claims and Insurance Job ID: 23-02862 Logistics Coordinator - Claims and Insurance Pay rate range: $28/hr. to $30/hr. on w2. Top 3 Skill Sets: Excel, SAP, Powerpoint Under the guidance of a manager, this position is responsible...

  • Claims Analyst, Risk Management

    4 weeks ago

    Santa Clara, United States INTEL Full time

    Conducts a variety of research and analytics to provide intelligence around new risk exposures and mitigation recommendations. Researches new insurance and risk transfer products and tools and associated recommendations on applicability for Intel. Collaborates with internal stakeholders, advisors, insurance brokers and insurers on risk exposure...