What are the responsibilities and job description for the Workers Compensation Claims Supervisor (Hybrid or Remote) position at TRISTAR RISK MANAGEMENT?
POSITION SUMMARY: Under minimal supervision, manages and directs the activity of a Self-Insured claims unit, ensuring high-quality results and management of claims in compliance with state laws and company/client procedures. This position requires considerable interaction with the client, management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work in the office in a timely manner is inherent to this position.
DUTIES AND RESPONSIBILITIES:
- Directly supervise examiners and clerical staff. Includes monitoring attendance, job performance, evaluations, and disciplinary issues. *
- Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.*
- Reviews and approves reserve changes, awards, and payments within Company and Client guidelines. *
- Performs file reviews to monitor compliance with policies and laws. *
- Establishes appropriate supervisory diaries on claim files and completes pending diaries on or before scheduled due dates. *
- Prepares for claim audits, reviews audit results, and provides appropriate rebuttal feedback.*
- Coordinates and leads training sessions for staff on updated laws, policies, and procedures.*
- Ensures daily caseload staffing requirements are met.*
- Responds to claimant and vendor concerns and issues as needed.*
- Ensures client servicing instructions are being adhered to.*
- Analyzes monthly client reports.*
- Facilitates internal and external audits.*
- Coordinate and attend client file reviews and staffing meetings in-person or telephonically.*
- Other duties as assigned, including supervision of other jurisdictions as needed*.
*Essential job function.
EQUIPMENT OPERATED/ USED: Computer, 10-key, printer, copier, fax machine and other office equipment.
SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire.
Qualifications:QUALIFICATIONS REQUIRED:
Education/Experience: Bachelor’s degree in related field (preferred); 5 (five) years related experience; or equivalent combination of education and experience.
Knowledge, Skills and Abilities:
- Technical knowledge of statutory regulations.
- Ability to work on a diary system, prioritize tasks, and meet strict deadlines.
- Strong analytical skills.
- Proficient in Word and Excel.
- Excellent written and verbal communication skills, including the ability to convey technical details to claimants, clients, and staff.
- Ability to manage employees of various skill levels.
- Excellent interpersonal skills.
Other Qualifications:
- Certifications and/or licenses as required by State regulation.
Mental and Physical Requirements: [see separate attachment attached for a copy of checklist of mental and physical requirements]
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MENTAL AND PHYSICAL REQUIREMENTS |
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Light work:
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FREQUENCY |
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Crouching: Crouching: Bending the body downward and forward by bending legs and spine.
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Occasionally |
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Stooping: Stooping: Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.
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Occasionally
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Kneeling: Bending legs at knee to come to a rest on knee or knees. |
Occasionally |
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Reaching: Extending hand(s) and arm(s) in any direction.
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Occasionally |
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Standing: Particularly for sustained periods of time.
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Occasionally |
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Walking: moving about on foot to accomplish tasks, particularly for long distances.
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Occasionally |
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Sitting: Body resting in an office chair while performing work, particularly for long periods of time.
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Frequently |
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Pushing: Using upper extremities to press against something with steady force in order to thrust forward, downward, or outward.
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Occasionally |
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Pulling: Using upper extremities to extend force in order to drag, haul, or tug objects in a sustained motion.
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Occasionally |
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Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.
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Occasionally |
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Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.
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Frequently |
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Grasping: Applying pressure to an object with the fingers and palm.
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Occasionally |
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Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
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Continually |
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Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication, and to make fine discriminations in sound, such a when making fine adjustment on machined parts.
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Frequently |
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Repetitive Motion: Substantial movement (motions) of the wrists, hands, and / or fingers. |
Frequently |
Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure. |
None Known |
Salary : $108,000 - $112,000