Claims Supervisor

ATHENS POSITION DETAILSPosition Title:Claims SupervisorDepartment:Workers’ CompensationReports To:Division Claims ManagerFLSA Status:ExemptJob Grade:14Career Ladder:Next step in progression could include Division Claims ManagerATHENS ADMINISTRATORSExplore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!Position SummaryAthens Administrators has an immediate need for a Claims Supervisor to support our Northern California Workers Compensation department. Management that lives less than 36 miles from the Concord office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Northern California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employee work a 37.5-hour work week with the ability to work a flex schedule with every third Monday or Friday off.As a Claims Supervisor, you'll play a pivotal role in leading and collaborating with Athens management to achieve exciting company goals, run insightful reports, and streamline processes. You'll make impactful daily claims decisions, review files for accuracy, and approve payments that exceed examiner authority. Additionally, you'll ensure top-notch file handling, accurate claims coding, and meet unit closing goals. You'll be the guiding force for your team, planning, organizing, delegating workloads, supervising daily activities, providing training, and offering valuable guidance. In client management, you'll address policy and claims issues, build and maintain strong relationships, attend key meetings, ensure compliance with client instructions, and document interactions, always acting in the client's best interest. Join us and make a difference every day!Primary ResponsibilitiesOur new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:Claims LeadershipWork with Athens management to achieve company initiatives and performance goalsConsistently strive to improve and streamline current processesAuthorize release of payment and settlementMake daily claims decisions regarding plan of action, handling of payment, etc.Review claim files for accuracyRun various reports with an eye for accuracy and confidentialityApprove payments and reserve increases when they rise above Examiner’s authority levelWork collaboratively with internal and clients’ senior management as well as with attorneys to draft settlements and assist with litigation strategiesProvide timely information to clients, attorneys, doctors, investigators and injured workers with strong, professional communicationDiscuss appropriateness of medical treatment with medical case managerAssure consistent and accurate claims coding is occurring on the teamEnsure quality file handling and resolution. This includes meeting unit closing goals, verifying proper reserves, providing thorough claims analysis and guiding to correct resolutionUse flexibility when working in demanding and changing situationsEmployee ManagementEffectively plan, organize and delegate workload for optimal results and to ensure time commitments are metSupervise daily activities of the team by monitoring progress, ensuring compliance with policies, and promptly addressing any issues or conflictsIdentify, coordinate, coach, and perform training with staff to improve performance and increase their growth and knowledge in claimsParticipate in the interview process, onboarding and training of new hiresProvide general guidance to the team by offering support and advice on work-related issues, fostering a positive work environment, encouraging professional development, and reviewing performance through evaluations, feedback, goal setting, and identifying areas for improvementProvide direct feedback and use sound coaching techniques to solve disciplinary or workflow problems. Manage and document employee relations issues at all levels. Work in conjunction with Human Resources to ensure performance issues are managed in a timely and consistent mannerRegularly lead organized and collaborative staff unit meetings, including both remote and on-site employeesMaintain an open-door policy and an approachable attitude, and foster open communication with staff Client ManagementWork with clients with issues regarding policies, programs and/or claimsManage existing client relationships by being accessible, making regular service calls, and proactively identifying and solving potential problemsAttend client meetings, internal meetings, and workers’ compensation meetings both virtual and in-personEnsure notepads and diaries are set and completed timely in accordance with client handling instructions and Athens Best Practices and have meaningful action plans and information and are concise and well-writtenObtain audit results meets or exceeds best practice standards of Athens and clientDisplay integrity and always acts in the best interest of the clientDocument client meeting notes in appropriate shared locationSupervisory ResponsibilitiesSupervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions.Provide direct supervision for 6-10 employees, typically consisting of Senior Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees.Attend on-site Leadership Summit at Athens Concord headquarters every 18 months (including overnight)Fiscal ResponsibilitiesReview and approve direct report’s monthly expense reportsEnsure that all expenditures are in the best interest of the CompanyUse effective monitoring and reporting mechanisms to control expenses without lowering qualitySearch for and implement hidden cost improvementsObtain, maintain, and demonstrate an understanding of wage and hour laws as applicable for employeesEnsure timely, accurate review and approval of timecards for your staff on payroll processing days.Essential Position RequirementsThe requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.Education & LicensingHigh School Diploma or GED required; AA/AS or BA/BS preferredMust possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)Administrators Certificate from Self-Insurance Plans. If not already obtained, the Administrators Certificate from Self-Insurance Plans will be required within one year of employmentCompletion of IEA or equivalent coursesExperienceMinimum 3+ years of recent California workers’ compensation claims handling experience at a high levelAt least 2 years of Claims Supervisory experience required5+ years’ experience in a workers’ compensation lead or supervisor position preferredPrior Third‑Party Administrator (TPA) experience preferredTechnical & Claims KnowledgeIn-depth knowledge of California workers’ compensation laws, policies, and proceduresProficiency in determining case value, reserving, and negotiating settlementsUnderstanding of medical and legal terminologyProficient in Microsoft Office Suite; ability to learn additional systems (e.g., ClaimsXpress)Ability to create reports using standard tools or custom document formatsAble to plan, prioritize, and organize claims workload for a unitLeverages technology for self and staff to improve efficiency.Leadership & Management SkillsAbility to lead by example, delegate effectively, and ensure timely task completion, even during stressful situations and tight deadlinesDemonstrated ability to influence, coach, and motivate staff to achieve unit and organizational goalsStrong organizational and time-management skills; able to plan, prioritize, and manage unit workloadsFlexible, adaptable, positive, and aligned with Athens ValuesAbility to develop and maintain effective working relationships with coworkers, clients, vendors, and key stakeholdersAnalytical & Problem-Solving SkillsStrong analytical, reasoning, and problem-solving skillsAbility to interpret information from multiple sources, draw logical conclusions, and make informed recommendationsAbility to exercise independent judgment in solving complex and sensitive problemsStrong mathematical calculation skills and high accuracy in work outputCommunication SkillsHighly developed written and verbal communication skillsSkilled at presenting to small and large groupsStrong attention to detail in documentation and communicationStrong and tactful negotiation skillsProfessional Conduct & Values AlignmentAthens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.Ability to handle confidential, proprietary, and highly sensitive information appropriatelyDemonstrates care, respect, and concern for team members and clients in a professional mannerActs with integrity in challenging situations and consistently supports company valuesEmbrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully.Seeks to include innovative strategies and methods to provide a high level of commitment to service and results.Other RequirementsValid driver’s license and ability to travel, including in-office file reviews and meetingsAbility to type quickly and accurately for sustained periodsAPPLY WITH USWe look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdfThis description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.THANK YOU!We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here