Claims Team Lead

4 weeks ago

Long Beach, California, United States Randstad USA Full time
Now Hiring: Claims Team Lead Apply today because openings are limited Overview To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

salary: $55 - $60 per hour
shift: First
work hours: 8 AM - 4:30 PM
education: Bachelors

Responsibilities
  • Supervises multiple teams of examiners, 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 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 review on claims in compliance with audit requirements, service contract requirements, and quality standards.
  • Acts as 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 client.
  • Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.

    Skills
  • Supervising (2 years of experience is required)
  • lead and motivate others (5 years of experience is required)
  • meet goals (5 years of experience is required)
  • meet deadlines (5 years of experience is required)
  • Claims (6 years of experience is required)
  • Claims Supervising Experience (2 years of experience is required)
    Qualifications
  • Years of experience: 5 years
  • Experience level: Manager
    Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

    Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

    At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

    Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

    Applications accepted on ongoing basis until filled.

    Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

    We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

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