The Claims Supervisor is responsible for supervising and monitoring the accuracy, timeliness, and quality of workers’ compensation claims within an assigned Texas claims unit. This position provides day-to-day leadership and technical claims guidance to staff, makes claims decisions, reviews files for accuracy, approves payments and reserve increases above examiner authority, and ensures quality claim handling and resolution.
The Claims Supervisor also manages team performance and development while maintaining productive client relationships and ensuring compliance with client handling instructions and established claims best practices.
Primary Responsibilities
Claims Leadership
Supervise the handling and resolution of Texas workers’ compensation claims.
Make claims decisions regarding plans of action, payments, reserves, settlements, and overall claim handling.
Review claim files for accuracy, quality, appropriate reserves, and proper resolution.
Authorize payments and settlements and approve payments and reserve increases above examiner authority levels.
Ensure consistent and accurate claims coding and documentation.
Monitor file quality, claims analysis, action plans, and unit closing goals.
Review and analyze claims reports for accuracy and performance.
Collaborate with management, clients, and attorneys regarding settlements and litigation strategies.
Communicate with clients, attorneys, medical providers, investigators, and injured workers.
Work with medical case management regarding the appropriateness of medical treatment.
Identify opportunities to improve and streamline claims processes.
Employee Management
Provide direct supervision for approximately 6–10 claims professionals.
Plan, organize, prioritize, and delegate team workloads.
Monitor daily team activities, claim progress, quality, and compliance.
Coach and train staff to improve claims knowledge and performance.
Participate in interviewing, onboarding, and training new employees.
Conduct performance evaluations, provide feedback, establish goals, and identify development opportunities.
Address performance, disciplinary, employee relations, and workflow issues in coordination with Human Resources as appropriate.
Lead regular team meetings and maintain open communication with staff.
Client Management
Work with clients regarding claims, policies, and program-related issues.
Maintain client relationships through regular communication, accessibility, and proactive problem-solving.
Ensure diaries, documentation, and action plans are timely, meaningful, well-written, and compliant with client handling instructions and claims best practices.
Monitor audit results to ensure claims handling meets applicable client and quality standards.
Document client meetings and significant communications.
Required Qualifications
Education & Licensing
High School Diploma or GED required; Associate or Bachelor’s degree preferred.
Texas Workers’ Compensation or All Lines License required
Experience
Minimum 3+ years of recent Texas workers’ compensation claims handling experience at a high level.
Minimum 2 years of Claims Supervisory experience required.
5+ years of workers’ compensation lead or supervisory experience preferred.