Workforce Absence Team Lead

To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims.

Responsibilities

• Supervises multiple teams of examiners and/or several technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews, and analyzes management reports and takes appropriate action.
• Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
• Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client. Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; provides written resumes of specific claims as requested by client. Assures that direct reports are properly licensed in the jurisdictions serviced. Ensures claims files are coded correctly and adequate documentation is made by claims examiners. Performs other duties as assigned. Supports the organization's quality program(s).

Skills & Qualifications

• Excellent oral/written communication skills including presentation skills
• PC literacy including Microsoft Office products
• Leadership/management/motivational skills
• Analytical/interpretive skills
• Strong organizational skills
• Excellent interpersonal/negotiation skills
• Ability to work in a team environment

Experience

• Six (6) years of claims experience or equivalent combination of education/experience required.
• Two (2) years of claims supervisory experience preferred.

Education

• Bachelor's degree from an accredited college/university preferred.

Why Join Us

• Grow your career with us.
• Experience our caring culture.
• Enjoy work-life balance.
• No limit to what you can achieve.

Benefits

• Comprehensive benefits package including medical/dental/vision/401(k)/matching/PTO/disability/life insurance/employee assistance/flexible spending accounts/additional voluntary benefits.