Claims Team Lead
Description :
- Maintain contact with team via Microsoft Teams and phone calls for teambuilding and to provide assistance
- Approve overlimit payments process according to procedure
- Review and approve new claim determinations and provide initial directions as to whether to delay, deny, accept
- Review and approve litigation referrals and investigation referrals
- Review mail of your team, provide direction as needed
- Monitor for hearing dates and need for settlement authority requests or staffing of legal issues as they arise with examiner, DA, Director (if needed), County Representative (if needed)
- Ensure team meets their monthly #’s for core duties (reports are sent to assist with this)
- Review and ensure Medata suspended payments (bill review payments pending approval by examiner) are reviewed / processed by examiners
- Review and approve benefit notices prepared by examiners to ensure accuracy prior to mailing
- Review and approve benefits payments that exceed examiner’s level and ensure appropriate documentation and paperwork is attached to the claim to support payment
- Ensure claim coding is accurate and required fields are updated
- Respond to email inquiries and phone calls to assist our customers
- Review claims for supervisor direction every 90 days or sooner depending on need
- Maintain diary on all claims with emphasis on lost time claims / and delays
Requirements :
- County of Los Angeles experience preferred
- Hybrid 2 days in office (flexible)
- 10 years of experience in workers compensation. Self-insurance certificate mandatory.
Claims Team Lead (Supervisor) Workers Compensation
To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; a...
Claims Team Lead
Job Description:Maintain contact with team via Microsoft Teams and phone calls for teambuilding and to provide assistanceApprove overlimit payments process according to procedureReview and approve new claim determinations and provide initial directions as to whether to delay, deny, acceptReview and ...
Claims Team Lead (Supervisor) - Workers Compensation
To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; a...
Workers Compensation Team Lead
Our client, a National Third Party Administrator, is looking for a Temporary Workers' Compensation Team Lead for their Ontario, CA branch. ...
Claims Team Lead (Supervisor) Workers Compensation
To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; a...
Claims Team Lead - Workers Compensation CA Experience
To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; a...
Claims Team Lead (Supervisor) - Workers Compensation
To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; a...
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