We are looking for Claims Team Lead - Workers Compensation for our client in Ontario, CA
Job Title: Claims Team Lead - Workers Compensation
Job Location: Ontario, CA
Job Type: Contract
Job Description:
Pay Range: $41hr - $46hr

• Maintain contact with team via Microsoft Teams and phone calls for teambuilding and to provide assistance.
• Approve overlimit payments process according to procedure.
• Review and approve new claim determinations and provide initial directions as to whether to delay, deny, accept.
• Review and approve litigation referrals and investigation referrals.
• Review mail of candidate team, provide direction as needed.
• Monitor for hearing dates and need for settlement authority requests or staffing of legal issues as they arise with examiner, DA, Director (if needed), County Representative (if needed).
• Ensure team meets their monthly # s for core duties (reports are sent to assist with this).
• Review and ensure Medata suspended payments (bill review payments pending approval by examiner) are reviewed/processed by examiners.
• Review and approve benefit notices prepared by examiners to ensure accuracy prior to mailing.
• Review and approve benefits payments that exceed examiner s level and ensure appropriate documentation and paperwork is attached to the claim to support payment.
• Ensure claim coding is accurate and required fields are updated.
• Respond to email inquiries and phone calls to assist our customers.
• Review claims for supervisor direction every 90 days or sooner depending on need.
• Maintain diary on all claims with emphasis on lost time claims/and delays.