Workers' compensation Supervisor

Job Details

Level: ExperiencedJob Location: Dallas - Irving, TX 75038Position Type: Full TimeEducation Level: High School Diploma or GEDSalary Range: $85,000.00 - $90,000.00 Salary/yearTravel Percentage: NoneJob Shift: DayJob Category: Admin - Clerical

POSITIONS SUPERVISED:  Directly:  Claims Examiners, Claims Assistants; may supervise Administrative Support

 

 

POSITION SUMMARY:  Under minimal supervision manages and directs activity of claims unit ensuring high-quality results and management of claims in compliance with state laws and company procedures.

 

This position requires considerable interaction with clients, management, other Claims Examiners, and other TRISTAR staff in the office and some in other locations; therefore, consistently being at work in the office, in a timely manner, is inherently required of 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 guidelines up to reserve authority of $250,000.00 and payment authority of $10,000
• Performs file reviews to monitor compliance with policies and laws. This is completed file by file, monthly reviews as required by client and agency file reviews. Coordinates and leads training sessions for staff on updated laws, policies and procedures.
• Ensures daily caseload staffing requirements are met and as equal as possible among direct reports.
• Supervises and approves priority payments; sign checks as warranted.
• Responds to claimant and vendor concerns and issues as needed.
• Monitors effectiveness of vendors and modifies panels as needed within Tristar and Account guidelines.
• Ensures client servicing instructions are being adhered to.

• Provides coverage for examiner vacancies due to vacation or vacancies.
• Prepares and evaluates monthly client reports.
• Facilitates internal and external audits.

• Conducts and documents in-house and outside educational sessions.
• Attends client file reviews.
• Partners with corporate office and sales/service team for RFP’s and client service issues.
• Adheres to Tristar’s Supervisor Best Practice Guidelines.
• Other duties as assigned.

 

*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:  High School Diploma or GED required; Bachelor’s degree in related field (preferred); three (3) to five (5) years related experience; or equivalent combination of education and experience. 

 

Knowledge, Skills and Abilities:         

• Technical knowledge of statutory regulations (TX) and medical terminology.
• Ability to work on a diary system, prioritize tasks and meet strict deadlines.<