Duties
The Claims Supervisor directly reports to the director of the Claims Department and is an integral member of the Claims Leadership Team. The Claims Supervisor is responsible for the analysis and management of claim files within their unit. Supervision includes: claim assignments, coverage analysis, established of and adherence to action plans in claim files, and appropriate resolution. The Claims Supervisor is charmed with managing pending claims, improving file quality and controlling department expenses. The Claims Supervisor will conduct the management of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the State of California. The Claims Supervisor is expected to function at a high level of expertise and competency, while consistently exercising good judgment and independent discretion. The Claims Supervisor is expected to support Company goals, Department Goals and advance Company values.
Responsibilities:
- Direct management of staff of examiners and their claim files
- Approve action plans in accordance with best practices
- Work with the examiner throughout the life of the claim
- Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of processing claims
- Actively execute appropriate claims activities to ensure consistent delivery of quality of claims service
- Compliance with state laws and regulations regarding claim handling
- Shared responsibility for department budget, which includes planning and ongoing management of salary and expenses
- Claim Management as measured through aggressive action plans and overall supervision as measured by reduction in average paid and average age of classes at time of closing
Benefits
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a competitive salary and excellent benefit package.
Requirements
- 5+ years of successful claim management/leadership experience
- Ability to mentor and motivate subordinate staff
- Strong written and verbal communication skills
- In-depth knowledge of appropriate legal principles
- In-depth knowledge of laws for worker's compensation
- Strong organizational skills
- Strong negotiation skills
- Bachelor's degree from an accredited college or university preferred
How to Apply
Send applications or resume to: CCareers@clinicas.org Fax: 805-659-3217
Is this job listing for a Provider?
No