Workers' Compensation Claims Management Lead

1 week ago


Scottsdale, Arizona, United States CCMSI Full time

Job Title: Workers' Compensation Claims Management Lead

Location: Scottsdale, AZ (Hybrid schedule after initial training period - 1 day in office per week + additional mandatory meetings/trainings)

Estimated Salary: $88,185.50

The role of a Workers' Compensation Claims Management Lead is to oversee the handling of workers' compensation claims. This includes supervising the investigation, adjustment, and overall management of these claims.

Key Responsibilities:

  • Claims Oversight: Manage and supervise the handling of workers' compensation claims, ensuring compliance with corporate standards and client-specific instructions.
  • Investigation and Adjustment: Conduct thorough investigations and adjustments of workers' compensation claims, establishing reserves within authority levels.
  • Bills and Settlements Review: Oversee medical, legal, and other invoices; negotiate and resolve disputed claims.
  • Claims Management: Approve claim payments within established procedures and make settlement decisions in line with corporate and state regulations.
  • Team Development: Mentor, train, and support claim staff, providing ongoing education and development opportunities.
  • Litigated Claims Management: Manage the handling of litigated and complex claims to ensure proper resolution.
  • Client and Vendor Relations: Collaborate with external vendors (e.g., legal, case management) to ensure appropriate handling of claims.
  • Compliance: Ensure all claims handling complies with Corporate Claim Handling Standards and client-specific protocols.
  • Additional Duties: Perform other duties as assigned by management.

Requirements:

  • Experience: 10+ years of experience in workers' compensation claims required, with 3+ years of supervisory experience preferred.
  • Education: Bachelor's degree preferred.
  • Skills: Strong communication, analytic, and negotiation skills. Ability to work under pressure in a fast-paced environment.
  • Technical Skills: Proficient with Microsoft Office Suite.
  • Certifications/Licenses: Adjuster's license may be required based on jurisdiction. AIC, CPCU, or ARM certifications preferred.
  • Physical Demands: Ability to sit or stand for extended periods; work involves frequent use of computers and communication tools.

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