Claims Supervisor Job Description
Claims supervisor
provides supervision, guidance, technical and educational support to a staff of workers' compensation adjusters handling lost-time and medical only claims, claims examiners, Nurse Case Managers and Claims Technicians in the adjudication of workers' compensation claims within the Pennsylvania Workers Compensation Act, UPMC Work Partners Claims Standards.
Claims Supervisor Duties & Responsibilities
To write an effective claims supervisor job description, begin by listing detailed duties, responsibilities and expectations. We have included claims supervisor job description templates that you can modify and use.
Sample responsibilities for this position include:
Attend daily/weekly/monthly calls
Contact the marketing rep, agent, underwriter (if needed), and the Decatur office to make them aware of any problems that arise in the field
Manage a multi-level team of up to 7 claims associates
Receive, record, process, and troubleshoot requests from clients and staff of the most complex in nature
Responsible for timely resolution of special projects
Monitor staff quality and ensure operational standards, policies, and procedures are followed to the service level agreements
Responsible for providing input to the hiring and disciplinary processes for administering performance appraisals for staff associates
Manage Inventory to meet service level agreements
Report on unit performance, productivity, and overall quality through a series of operational reports
Evaluate and control workflow within the team
Claims Supervisor Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Claims Supervisor
List any licenses or certifications required by the position: ASE, ICAR, I.E.A, S.I.P, AIC
Education for Claims Supervisor
Typically a job would require a certain level of education.
Employers hiring for the claims supervisor job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Education, Business, Healthcare, Business/Administration, Management, Associates, Health Care, Finance, Accounting, Medical
Skills for Claims Supervisor
Desired skills for claims supervisor include:
Team member related functions
Entire claims administration
Case management and cost containment solution as applicable to Workers’ Compensation
Insurance claims operations
Specifically of Shelter's policies and claims procedures is strongly
WI
Workers Comp
WC
Microsoft Office Suite
Medical terminology
Desired experience for claims supervisor includes:
Bachelor's degree and two years of previous medical management claims adjusting or equivalent experience, required
Monitors claim staff for attendance, punctuality, and performance measurements
Proactively manage departmental performance, to achieve quality, compliance and productivity targets
Lead by example and serve as a role model, set & maintain high ethical standards
Monitor external environments for trends and best practices and implement appropriate action plans
Manage complex and difficult negotiations, influence stakeholders to achieve desired outcomes
Claims Supervisor Examples
1
Claims Supervisor Job Description
Job Description Example
Our company is growing rapidly and is looking for a claims supervisor. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for claims supervisor
- Responsible for handling of the following tasks within turnaround and quality standards as applicable
- Able to run macros as need and identify additional automation needs to increase the auto vs manual
- Assists with staff coaching, performance planning, and development
- Assists with the development and revision of processes and procedures
- Provide daily direction and communication to team of up to 20 agents so that customer service calls are answered in a timely, efficient, and knowledgeable manner
- Provide continual evaluation of processes and procedures, which includes reviewing agent calls and providing evaluations for improvement/development
- Train new agents and re-train tenured agents on new processes to improve the customer experience
- Monitoring real time service levels and schedule adherence
- Monitor agent call metrics and develop corrective action plan when necessary
- Provide regularly scheduled one-on-one coaching with Contact Center Representatives Address escalated customers’ questions and concerns
Qualifications for claims supervisor
- Experience with CMAX (Claims Management Technology), YARDI systems, FHA Connection and MSP Mortgage Loan Servicing system
- Strong background using MS Office (Excel, Word, Access, Visio, PowerPoint)
- Able to successfully manage multiple tasks and projects
- Associate's degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field required
- Moderate proficiency with Windows PC applications - Word (Ability to create/edit document)
- Ensure information flow of updates and changes to agents Implement plans for developing and motivating agents
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Claims Supervisor Job Description
Job Description Example
Our company is hiring for a claims supervisor. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for claims supervisor
- Update and monitor KPI whiteboards for daily visibility of team’s performance
- Onboard and mentor new team members for system setup and getting acclimated to their new team
- Interview potential Complex Claims Specialist candidates for open positions in the department
- Manage team and individual daily workloads to drive excellent revenue performance for CEA’s customers through strong ownership of customers’ Key Performance Indicators (KPI)
- Continuously review processes and suggest process improvements to reduce cost and increase performance through eliminating non-value added work
- Provide constant feedback to leadership about concerns, resource needs and positive trends to ensure effective communication
- Collaborate with on-site team members at CEA’s customer sites to ensure expedited claims resolution
- Resolve any patient and/or customer escalations as needed
- Assist in developing budgets for department in conjunction with Manager
- Practices LEAN and continuously analyze data and feedback for trends, reasons, system issues to identify performance improvement initiatives
Qualifications for claims supervisor
- Demonstrates inner strength
- Strong focus on selection – determined to have the right people who do the best job
- Desire to developing talent
- Minimum 5 years claims experience, strongly prefer 3 years in a People Leadership capacity
- Recognized Degree holder with major(s) in Biology, Pure Science, Biomedical Sciences, or related field
- Good command of spoken and written English Language, Bahasa Malaysia and Mandarin
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Claims Supervisor Job Description
Job Description Example
Our company is hiring for a claims supervisor. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for claims supervisor
- Coordinates communications throughout the Company related to claims processes and initiatives
- Full understanding of all claim types and the respective processing - originals, resubmissions, voids
- Collaborate with operational partners to help improve claims processing workflows, efficiencies
- Supervise and direct the activities of the Claims/REO Department to ensure compliance with internal policies and procedures, investor guidelines and applicable state and federal laws and regulations
- Monitor all claims are filed in accordance with investor/agency/insurer requirements
- Participate in the implementation/development of procedures to increase efficiency
- Participate in weekly/monthly conference calls with clients providing status of the defaulted portfolio
- Manage eviction and property preservation needs for agency and private loans
- Prepare response for internal QC audits
- Prepare monthly MBR’s and present to Management
Qualifications for claims supervisor
- Good understanding of legal proceedings and ability to work with attorneys
- Flexible in workload to handle crisis situations, last-minute changes, and immediate deadlines while handling stressful situations in a calm and logical manner
- Experience of managing teams of people and work throughput
- Excellent communication skills with the ability to relay information clearly and concisely in both written and verbal communications
- Have well developed planning and organisational skills
- Ability to manage workflow to ensure SLAs are achieved
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Claims Supervisor Job Description
Job Description Example
Our innovative and growing company is hiring for a claims supervisor. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for claims supervisor
- Works closely with Data Services, Client Services, and Claims Services teams to understand project requirements and advise on best practices for project setup
- Conducts risk analysis
- Investigates client and internal customer complaints, concerns, and non-conformance issues
- Supports on-site audits conducted by external providers / clients
- Enhances department and organization reputation by taking ownership for quality and accuracy of output of the department
- Supervises multiple teams of examiners, single or multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control
- Assigns correspondence to staff and monitors their completion/resolution
- Reviews reports/correspondence completed by staff for completeness and appropriateness for recommendations
- Trains staff on new and revised policies and procedures related to eligibility, correspondence processing, document processing, or other benefit related policies and procedures
- Interprets policies to staff, employees, covered dependents, and service providers
Qualifications for claims supervisor
- 1+ years experience supervisory/management of 10+ team members
- This position is open to current Treasury employees only *
- Valid examiners license in appropriate jurisdictions or ability to obtain such
- Minimum five years insurance experience handling auto and casualty claims
- Leadership, project management, communication, analytical, problem solver
- Demonstrated ability to synthesize and interpret information for communication to senior management
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Claims Supervisor Job Description
Job Description Example
Our company is growing rapidly and is looking for a claims supervisor. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for claims supervisor
- Retain and supervise directly defense counsel and claim investigators
- Lead the defense team in coordinating case strategy with all stakeholders, including external or internal investigators, defense counsel, hospital Risk Management and other Corporate Departments
- Assign indemnity and expense reserves supported by the ongoing analysis of cases and appropriately document the rationale for decision
- Maintain claim caseload on a regular review schedule and diary
- Effectively participate in settlement negotiations, mediations and trials as required for optimal outcomes
- Identify and analyze claims and prepare summaries and reports as needed for presentation to Director of Claims (also for AVP, VP, Claims Committee and excess and reinsurers as needed)
- Maintain accuracy of claims data in electronic claims system
- Approve claims expenses and litigation fees as appropriate
- Actively participate in committees or task forces as assigned that call for claims input and experience
- Develop and maintain effective, efficient and respectful working relationships with various facility representatives and leaders
Qualifications for claims supervisor
- Ability to take and provide clear direction
- Minimum 3 years’ experience in healthcare industry
- Knowledge of technical concepts pertaining to processing software preferred
- Knowledge of technical writing concepts preferred
- Previous benefits management and administration experience
- Previous experience drafting communications