Athens Administrators

ATHENS POSITION DETAILS Position Title: Claims Supervisor Department: Workers' Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Division Claims Manager ATHENS ADMINISTRATORS Explore 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 SUMMARY Athens Administrators has an immediate need for a Claims Supervisor to support our Southern California Workers Compensation department. Management that lives less than 36 miles from the Orange, CA 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 Southern 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 RESPONSIBILITIES Our 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 Leadership Work with Athens management to achieve company initiatives and performance goals Consistently strive to improve and streamline current processes Authorize release of payment and settlement Make daily claims decisions regarding plan of action, handling of payment, etc. Review claim files for accuracy Run various reports with an eye for accuracy and confidentiality Approve payments and reserve increases when they rise above Examiner's authority level Work collaboratively with internal and clients' senior management as well as with attorneys to draft settlements and assist with litigation strategies Provide timely information to clients, attorneys, doctors, investigators and injured workers with strong, professional communication Discuss appropriateness of medical treatment with medical case manager Assure consistent and accurate claims coding is occurring on the team Ensure quality file handling and resolution. This includes meeting unit closing goals, verifying proper reserves, providing thorough claims analysis and guiding to correct resolution Use flexibility when working in demanding and changing situations Employee Management Effectively plan, organize and delegate workload for optimal results and to ensure time commitments are met Supervise daily activities of the team by monitoring progress, ensuring compliance with policies, and promptly addressing any issues or conflicts Identify, coordinate, coach, and perform training with staff to improve performance and increase their growth and knowledge in claims Participate in the interview process, onboarding and training of new hires Provide 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 improvement Provide 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 manner Regularly lead organized and collaborative staff unit meetings, including both remote and on-site employees Maintain an open-door policy and an approachable attitude, and foster open communication with staff Client Management Work with clients with issues regarding policies, programs and/or claims Manage existing client relationships by being accessible, making regular service calls, and proactively identifying and solving potential problems Attend client meetings, internal meetings, and workers' compensation meetings both virtual and in-person Ensure 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-written Obtain audit results meets or exceeds best practice standards of Athens and client Display integrity and always acts in the best interest of the client Document client meeting notes in appropriate shared location Supervisory Responsibilities Supervising, 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 Responsibilities Review and approve direct report's monthly expense reports Ensure that all expenditures are in the best interest of the Company Use effective monitoring and reporting mechanisms to control expenses without lowering quality Search for and implement hidden cost improvements Obtain, maintain, and demonstrate an understanding of wage and hour laws as applicable for employees Ensure timely, accurate review and approval of timecards for your staff on payroll processing days. ESSENTIAL POSITION REQUIREMENTS The 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 & Licensing High School Diploma or GED required; AA/AS or BA/BS preferred Must 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 employment Completion of IEA or equivalent courses Experience Minimum 3+ years of recent California workers' compensation claims handling experience at a high level At least 2 years of Claims Supervisory experience required 5+ years' experience in a workers' compensation lead or supervisor position preferred Prior Third Party Administrator (TPA) experience preferred Technical & Claims Knowledge In-depth knowledge of California workers' compensation laws, policies, and procedures Proficiency in determining case value, reserving, and negotiating settlements Understanding of medical and legal terminology Proficient in Microsoft Office Suite; ability to learn additional systems (e.g., ClaimsXpress) Ability to create reports using standard tools or custom document formats Able to plan, prioritize, and organize claims workload for a unit Leverages technology for self and staff to improve efficiency. Leadership & Management Skills Ability to lead by example, delegate effectively, and ensure timely task completion, even during stressful situations and tight deadlines Demonstrated ability to influence, coach, and motivate staff to achieve unit and organizational goals Strong organizational and time-management skills; able to plan, prioritize, and manage unit workloads Flexible, adaptable, positive, and aligned with Athens Values Ability to develop and maintain effective working relationships with coworkers, clients, vendors, and key stakeholders Analytical & Problem-Solving Skills Strong analytical, reasoning, and problem-solving skills Ability to interpret information from multiple sources, draw logical conclusions . click apply for full job details