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Claims Management Supervisor

2 months ago

Fresno, California, United States Zenith Full time

This position offers the opportunity to engage in Zenith's flexible hybrid work model, allowing for a blend of remote and in-office work as per the established schedule by regional leadership.

Essential Qualifications:

Applicants must possess experience in Workers' Compensation and hold the necessary state certifications.

Under general oversight, this role entails the management and supervision of a Claims unit. The supervisor will provide technical direction and training to team members, assessing their performance against branch and corporate objectives.

Key Responsibilities:

  • Oversee and guide the assigned Claims unit(s) with a focus on technical and supervisory support.
  • Assess team performance in alignment with Zenith's established standards.
  • Conduct performance evaluations and recommend salary adjustments in accordance with company policies.
  • Participate in the recruitment process and provide training for new hires within the unit.
  • Manage Claims for cases assigned to the unit, including special accounts, adhering to performance standards and regulatory requirements.
  • Analyze Claims, establish reserves, determine liability, authorize benefit payments, and settle Claims within designated financial limits.
  • Ensure timely investigation assignments and rehabilitation referrals, including programs for early return to work.
  • Assign cases to the Special Investigations Unit as necessary.
  • Optimize the use of company medical cost containment initiatives.
  • Prepare litigation cases thoroughly for mediation and trials.
  • Maintain professional communication with policyholders, injured workers, and other stakeholders.
  • Assist in the preparation of agent status reports and policyholder claim assessments.
  • May serve as the account coordinator for major policyholders.
  • Utilize logical reasoning to identify problems, gather data, establish facts, and draw valid conclusions.
  • Collaborate effectively with colleagues consistently.
  • Respond constructively to feedback and performance evaluations.
  • Maintain a professional demeanor at all times.
  • Perform additional duties as assigned.
Education, Skills, and Requirements:
  • High School Diploma or equivalent is required.
  • Bachelor's Degree or a combination of relevant training and experience is necessary.
  • A minimum of 6 years of experience in handling Workers' Compensation indemnity Claims, including negotiation of litigated Claims, is required.
  • Demonstrated supervisory potential is essential; prior experience or education through seminars is preferred.
  • In-depth knowledge of regulatory requirements and current case law is required.
  • Strong verbal and written communication skills are necessary.
  • Proficiency in PC usage is required.
  • Excellent time management, organizational, and negotiation skills are essential.
  • Must meet all state regulatory standards regarding licensing and continuing education.
The anticipated salary range for this role is $97,120.17-$121, with actual compensation adjusted based on experience, location, and other job-related factors as permitted by law. Qualifications may justify placement in a different job level.