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Workers' Compensation Claims Supervisor

Association County Commissioners of Georgia (ACCG)


Listing Summary

Candidate selected to fill this position must live within the state of Georgia. The employee’s telecommuting work site location will contain a designated and approved workspace at the employee’s home address.

Applicants are asked to submit their resume to HR@ACCG.org. 

General Definition of Work

Incumbent performs advanced level professional work administering and supervising the investigation and handling of insurance claims for ACCG Insurance Division programs, ensuring compliance with the State of Georgia's filing requirements for insurance claims, and related work as apparent or assigned. Work is performed under the supervision of the Director of Claims. Continuous supervision is exercised over Senior Claims Examiners and Claims Examiners.

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential function satisfactorily.  The requirements listed below are representative of the knowledge, skill and/or ability required.  Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

Position Responsibilities

Claims Administration and Operation Management

  • Supervise the day-to-day operations of the Association's workers' compensation unit;
  • Review files that are assigned to examiners; review and approve reserves and payments for claims;
  • Monitor workflow and caseloads of assigned personnel;
  • Evaluate insurance claims filed through ACCG Insurance Division programs to determine claim type and provide initial instructions to claims examiners;
  • Review and approve a variety of unit status reports, settlement authority requests, excess reports, denied claims, pre-trial reports, vendor usage, payments and reserves;
  • Receive and respond to inquiries and requests for information from members, injured employees, vendors, case managers, legal representatives, and medical providers;
  • Review lawsuits for coverage; determine coverage exclusions that may apply;
  • Review closed claim files; complete claim file audits for benchmarking and to measure adherence to established claim quality standards; prepare summaries of claims pending for Association members as requested;
  • Review and reconcile deductible billing process and errors; review Electronic Data Interchange (EDI) submission and error resolution for state filings;
  • Provide and model outstanding customer service, teamwork, and organizational commitment;
  • Support the overall organization by executing the directives as set forth by the Executive Director or their designee;
  • Occasional overnight travel required, less than 15 days per year (i.e. LGRMS led training sessions).

Training and Supervision

  • Coach and develop assigned personnel skill sets;
  • Serve as hiring manager in the recruitment and selection of assigned personnel;
  • Assign and direct work tasks and evaluate the performance of assigned personnel;
  • Recognize outstanding performance and pursue remediation of inadequate performance of assigned personnel;
  • Recommend personnel responsibility and status changes when necessary to Director of Claims, Executive Director, or their designee;
  • Develop schedules and approve leave requests of assigned personnel in collaboration with Department Director.

Knowledge, Skills and Abilities

Incumbent possesses:

  • Thorough knowledge of the principles, practices, and process of insurance claims handling and administration, workers' compensation system requirements, and medical only claim administration;
  • Ability to establish and maintain effective working relationships with associates, claimants, attorneys, Nurse Case Managers, physicians, local government officials, customers, and the general public.
  • Thorough knowledge of standard office practices, procedures, equipment, and administrative support techniques; ability to operate a variety of standard office equipment including personal computer and associated software; ability to type accurately at a reasonable rate of speed.
  • Skill in the use of standard office software applications, specifically Microsoft Office products, including Outlook, Word and Excel;
  • Thorough knowledge and execution of business English, spelling and arithmetic, and the ability to communicate ideas effectively in both oral and written formats;
  • Ability to follow oral and written instructions, read, and understand detailed and complicated policies, procedures and materials that contain specialized words and phrases.

Education and Experience:

  • Bachelor's degree with coursework in business administration, insurance, or related field preferred;
  • Extensive (typically 10-15 years) experience of an increasingly responsible nature in workers' compensation claims handling and administration, including moderate supervisory experience required;
  • Possession of an Independent Adjusters License issued through the State of Georgia Insurance Department;
  • Proven experience leading and developing subordinates; exhibited ability to successfully work and lead in a remote work setting.

Special Requirements

  • Candidate selected is required to have and maintain a high-speed, broadband internet connection at their work site that is sufficient to enable fast, consistent service to the membership. A minimum download speed of 25 Mbps is required. To ensure a consistent speed at this level, a 40MB internet connection is recommended. Applicants may check your download speed at www.speedtest.net .
  • Valid driver's license in the State of Georgia

Applicants are asked to submit their resume to HR@ACCG.org. 

 

Listing ends on:

10/17/2022