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Claims Supervisor

1 month ago

Ontario, United States BCForward Full time
Job DescriptionJob Description

BCForward is currently looking for  Claims Supervisor - Workers Compensation  - Ontario, CA 91764 Hybrid 

 

Position Title:  Claims Supervisor - Workers Compensation
Location: Ontario, CA 91764 Hybrid (2 days in the office per week; initial 3 days in the office for training)
Expected Duration: 3 months

Anticipated Start Date: 12/2/2024

Pay Range: $60.00/hr on W2
Experience Required: 5+ years of California Workers' Compensation (WC) experience and SIP Certification
 

Job Description:
 

Primary Purpose:

The Workers' Compensation Claims Examiner is responsible for analyzing complex or technically difficult workers' compensation claims, ensuring that benefits are correctly determined and provided. The role involves working with high-exposure claims that may include litigation and rehabilitation, managing the claims process to ensure service expectations, best practices, and client requirements are met. This position also involves identifying subrogation opportunities and negotiating settlements.

 

Essential Functions and Responsibilities:

  • Claim Analysis & Resolution: Investigate and gather information to assess the exposure of complex workers' compensation claims. Develop action plans for timely and appropriate resolution of claims.
  • Settlement Negotiation: Approve and negotiate claim settlements within the designated authority.
  • Reserving & Payments: Calculate and assign timely and adequate reserves to claims. Approve and make timely payments and adjustments as needed.
  • State Filings: Ensure proper preparation of necessary state filings within statutory limits.
  • Litigation & Vendor Coordination: Manage the litigation process and coordinate vendor referrals for investigation and/or litigation management.
  • Cost Containment: Apply cost containment strategies, including using vendor partnerships, to reduce claim costs.
  • Claim Recoveries: Manage recoveries including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets.
  • Excess Carrier Reporting: Report claims to excess carriers and respond to inquiries in a timely and professional manner.
  • Communication: Maintain clear communication with claimants and clients about the claim's status, ensuring professional relationships are maintained.
  • Claim Documentation: Ensure claim files are properly documented, and claim coding is accurate.
  • Referral to Management: Refer complex cases to management in accordance with client service instructions.

 

Additional Functions and Responsibilities:

  • Perform other duties as assigned by management.
  • Support organizational quality programs and initiatives.
  • Travel as required for business purposes.

 

Qualifications:

Education & Licensing:

  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to the line of business is preferred.

Experience:

  • At least 5 years of claims management experience, with expertise in California Workers' Compensation, or an equivalent combination of education and experience.

Skills & Knowledge:

  • In-depth knowledge of insurance principles and laws, including cost containment, medical management, and Social Security/Medicare application procedures.
  • Excellent oral and written communication, presentation, and interpersonal skills.
  • Strong analytical, interpretive, and organizational skills.
  • Ability to manage multiple priorities and meet deadlines.
  • Strong negotiation skills and the ability to work effectively in a team environment.
  • Proficient in Microsoft Office and other PC-based applications.

 

Work Environment:

  • Mental: Strong problem-solving, analysis, and judgment skills are required. Ability to manage stress, prioritize tasks, and meet deadlines.
  • Physical: Primarily involves computer keyboarding, with some travel as needed.
  • Auditory/Visual: Must have normal hearing, vision, and communication abilities to interact effectively in the role.
Company DescriptionAbout BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.

BCforward is an equal opportunity employer. All qualified applicants willCompany DescriptionAbout BCforward:\r
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.\r
\r
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.\r
\r
BCforward is an equal opportunity employer. All qualified applicants will