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Job Number: 19015447589
Position Title: Claims Supervisor
Location: San Antonio, TX
Description:

POSITION: Claims Supervisor

COMPANY: TRISTAR

DEPARTMENT: San Antonio, TX 210400

REPORTS TO: Branch Manager

STATUS: Exempt

DATE PREPARED:  8/2/2018

 

POSITIONS SUPERVISED: Directly: Claims Examiners, Claims Assistants

 

 

POSITION SUMMARY: Under minimal supervision manages and directs activity of claims unit ensuring high-quality results and management of claims in compliance with state laws and company procedures.

This position requires considerable interaction with clients, management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.

 

 

DUTIES AND RESPONSIBILITIES:

 

·       Directly supervises examiners and clerical staff. Includes monitoring attendance, job performance, evaluations and disciplinary issues.

·       Reviews and addresses scheduled claims issues, such as initial and periodic reviews, delays, denials, etc.

·       Reviews and approves reserve changes, awards and payments within Company guidelines

·       Performs file reviews to monitor compliance with policies and laws.*   This is completed file by file, monthly reviews as required by client and agency file reviews.

·       Coordinates and leads training sessions for staff on updated laws, policies and procedures.*

·       Ensures daily caseload staffing requirements are met.*

·       Supervises and approves priority payments; sign checks

·       Responds to claimant and vendor concerns and issues as needed.* 

·       Monitors effectiveness of vendors and modifies panels as needed.*

·       Ensures client servicing instructions are being adhered to.*

·       Provides coverage for examiner vacancies due to vacation or vacancies.*

·       Prepares and evaluates monthly client reports.*

·       Facilitates internal and external audits.*

·       Conducts and documents in-house and outside educational sessions.

·       Attends client file reviews.

·       Partners with corporate office and sales/service team for RFP’s and client service issues.

·       Other duties as assigned.

 

*Essential job function.

Required Skills:

QUALIFICATIONS REQUIRED:

Education/Experience: Bachelor’s degree in related field (preferred); three (3) to five (5) years related experience; or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

·       Technical knowledge of statutory regulations and medical terminology.

·       Ability to work on a diary system, prioritize tasks and meet strict deadlines.

·       Strong analytical skills.

·       Proficient in Word and Excel.

·       Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.

·       Ability to manage employees of various skill levels.

·       Excellent interpersonal skills.

 

Other Qualifications:

·       Texas Workers’ Compensation License

 

Position Available: 01/23/2019
Date Posted: 01/23/2019
 
Contact Information: Tristar Insurance
Shannon Waters
5624956600
Email resume and salary requirements to: shannon.waters@tristargroup.net
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