Workers Compensation Team Leader (Assistant Supervisor)

POSITION SUMMARY: Under the oversight of the WC Claims Supervisor and Area Manager, the WC Claims Team Leader provides day-to-day supervision, technical guidance, and operational support to a claim's unit of 10 or more claims personnel, including Claims Examiners and support staff. The Team Leader works directly with Unit Management, Client Services, and clients as a technical expert and advisor to promote consistent claims handling, quality, and compliance with company Best Practices, Customized Handling Instructions, and applicable statutory and regulatory requirements. This position guides and mentors assigned staff, oversees team performance and workflow, conducts quality reviews, and partners with the Claims Supervisor on escalated claims, training needs, and performance-related matters. This position does not carry a personal caseload.

DUTIES AND RESPONSIBILITIES:

• Supervise a claims unit of ten (10) or more claims personnel, including Claims Examiners and support staff.
• Provide day-to-day work directions, technical guidance, and operational support to assigned staff.
• Work directly with Unit Management, Client Services, and clients as a technical expert and advisor on workers' compensation claims and claims-handling practices.
• Ensure compliance with company Best Practices, Customized Handling Instructions, applicable statutory and regulatory requirements, and established claims-handling procedures.
• Guide, coach, and mentor assigned staff; oversee team performance, work quality, and workflow; and identify training and development needs.
• Monitor work assignments, claim inventories, diary compliance, and timely completion of required claim activities.
• Conduct independent claim-file and quality reviews to evaluate claims-handling quality, reserve accuracy, documentation, compliance, and adherence to established action plans.
• Review and interpret applicable policies, endorsements, coverage provisions, and relevant laws to provide guidance on coverage, liability, exposure, and appropriate claims-handling strategies.
• Review and approve authority requests submitted by assigned Claims Examiners within delegated authority levels and direct staff to obtain additional authority when required.
• Provide technical guidance on complex claims, litigation, negotiations, and settlements within established authority levels.
• Communicate professionally and effectively with clients, claimants, legal counsel, service providers, vendors, management, and internal staff regarding claim status, issues, and resolution strategies.
• Ensure assigned staff maintain effective diary systems and thoroughly document claim activity, evaluations, decisions, communications, and action plans.
• Promptly communicate significant claim developments, coverage concerns, litigation issues, exposure changes, and recommended strategies to the Claims Supervisor, Area Manager, and client, as appropriate.
• Partner with the Claims Supervisor to address performance-related concerns and provide feedback regarding staff development, technical proficiency, and work quality.
• Identify and escalate workflow concerns, quality issues, client-service matters, and other operational risks to the Claims Supervisor or Area Manager.
• Perform other duties as assigned.

EQUIPMENT OPERATED/USED: Computer and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire when on video or attending client meetings.

QUALIFICATIONS REQUIRED:

Education/Experience: 5 - 7 years of WC experience- Managing cities, counties, public Municipalities a plus. Bachelor's degree in a related field (preferred); three (3) or more years of related experience; or equivalent combination of education and experience.

Knowledge, Skills, and Abilities:

• Technical knowledge of coverage, statutory regulations, and medical terminology.
• Analytical skills.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff.
• Ability to interact with people at all levels in the business environment.
• Ability to independently and effectively manage very complex claims.
• Proficient in Word and Excel (preferred).

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

MENTAL AND PHYSICAL REQUIREMENTS

• MENTAL EFFORT
• Reasoning development:

Follow one- or two-step instructions, routine, repetitive task.

Carry out detail but uninvolved written or verbal instructions, deal with a few concrete variables.

Follow written, verbal, or diagrammatic instructions, several concrete variables.

X Solve practical problems; variety of variables with limited standardization; interpret instructions.

Logical or scientific thinking to solve problems; several abstract and concrete variables.

Wide range of intellectual and practical problems; comprehend most obscure concepts.

b. Mathematical development:

Simple additional and subtraction; copying figures, counting, and recording.

Add, subtract, multiply, and divide whole numbers.

X Arithmetic calculations involving fractions, decimals, and percentages.

Arithmetic, algebraic, and geometric calculations.

Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination requires theoretical application.

c. Language development:

Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

X Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

Ability to report, write, or edit articles for publication; prepare deeds, contracts, or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

• PHYSICAL EFFORT
• Physical activity required to perform the job:

Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work

involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

X Light work:

• Exerting up to 20 pounds of force occasionally
• Exerting up to 10 pounds frequently
• Exerting a negligible amount of force constantly to move objects

(If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).

Medium work:

• Exerting up to 50 pounds of force occasionally
• Exerting up to 20 pounds of force frequently
• Exerting up to 10 pounds of force constantly to move objects

Heavy work:

• Exerting up to 100 pounds of force occasionally
• Exerting up to 50 pounds of force frequently
• Exerting up to 20 pounds of force constantly to move objects

Very heavy work:

• Exerting in excess of 100 pounds of force occasionally
• Exerting in excess of 50 pounds of force constantly to move objects
• Exerting in excess of 20 pounds of force constantly to move objects

b. Visual requirements necessary to perform the job:

Far vision: clarity of vision at 20 feet or more

X Near vision: clarity of vision at 20 inches or less

X Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet

Depth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually are

Color vision: ability to identify and distinguish colors

Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point

2. PHYSICAL EFFORT (cont.)

FREQUENCY

c. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):

Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility is emphasized. This factor is important if the amount and kind of climbing

Balancing:

X Stooping:

X Kneeling:

X Crouching:

Crawling:

X Reaching:

X Standing:

X Walking:

X Pushing:

X Pulling:

Foot

Motion:

X Lifting:

X Fingering:

X Grasping:

required exceeds that required for ordinary locomotion.

Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.

Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.

Bending legs at knee to come to a rest on knee or knees.

Bending the body downward and forward by bending legs and spine. Moving about on hands and knees or hands and feet.

Extending hand(s) and arm(s) in any direction. Particularly for sustained periods of time.

Moving about on foot to accomplish tasks, particularly for long distances.

Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.

Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.

Using feet to push pedals.

Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.

Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.

Applying pressure to an object with the fingers and palm.

Occasionally

Occasionally Occasionally

Occasionally Occasionally Occasionally Occasionally

Occasionally

Frequently

Frequently

Occasionally

2. PHYSICAL EFFORT (cont.)

FREQUENCY

X Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.

X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication, and to

Frequently

Frequently

make fine discriminations in sound, such as when making find adjustments on machined parts.

Feeling: Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.

X Repetitive Substantial movements (motions) of the wrists, hands, Motion: and/or fingers.

Frequently

3. WORKING CONDITIONS

Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure.

WORKING CONDITION ENVIRONMENTAL FACTOR

NATURE/REASON OF EXPOSURE

FREQUENCY

Dirt/Dust

Noise

Temperature extremes

Dampness

Vibrations

Equipment movement hazard

Chemicals/solvents

Electrical shock

Significant work pace/pressure

Odors/Fumes

Other (specify):