Claims Supervisor, Workers' Compensation - Negaunee, MI

 

CLAIM YOUR FUTURE AS A GREAT PERFORMER!

 

Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities.  We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment.  We are proud to have been recently voted the Best TPA in America and the first and only Third Party Administrator to receive the coveted Employer of Choice? designation.  Come be a part of our team and "Claim Your Future."


PRIMARY PURPOSE: To supervise the operation of teams which administer workers, compensation claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on all claims in the team(s) including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office Provides technical/jurisdictional direction to examiner reports on claims adjudication Compiles, reviews and analyzes management reports and takes appropriate action Performs quality review on workers' compensation claims in compliance with audit requirements, service contract requirements, and quality standards Acts as second level of appeal for calls to/from client and employees regarding claim specific, procedural or special requests; implements final disposition of the appeal Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner Monitors all third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client Maintains contact with the client on claims and promotes a professional client relationship; provides recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims service
SUPERVISORY RESPONSIBILITIES:Administers company personnel policies in all areas and follows company staffing standards and training recommendations Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions Provides support, guidance, leadership and motivation to promote maximum performance

Education & Licensing:

Baccalaureate degree from an accredited college or university preferred
Licenses as required
Professional certifications as applicable to Workers' Compensation preferred
Experience:

Six (6) years of claims management experience required
Supervisory experience preferred


 


Skills & Knowledge:

Excellent oral and written communication skills, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Good technical knowledge of claims management
Ability to meet or exceed Performance Competencies


 Sedgwick CMS is an Equal Opportunity Employer