Medical Only Claims Supervisor

At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.

• This position is eligible to work from home anywhere in the United States**
  
  

Supervises a Workers’ compensation Medical Only (MO) claim team, responsible for high volume, low severity, all-jurisdiction medical-only claims. Reviews new files assigned to team and oversees the handling of claims. Promptly reassigns cases outside of the parameters of the MO team. Develops and fosters excellent onboarding and training of new team members and fosters their growth. Oversees and monitors the workload and performance of the team.

Essential Functions

• Leads and oversees the assignment of claims to the appropriate medical only (MO) claims representative based on the appropriate jurisdictional skill set required after reviewing the loss notice
• Provides direction and recommendations for claims handling to team, including any necessary training identified
• Guides team through issues pertaining to questions of coverage, compensability, claim value and strategy for resolution and coordinates decisions to reassign files to indemnity team
• Provides updates to team regarding state and regulatory requirements and ensures all team members are up to date on changes to ensure compliance on behalf of EMC
• Ensures claim files comply with the company’s MO best practices and EMC’s claims philosophy
• Coordinates staff participation in interactive Roundtables. Ensures claim payments/ mileage reimbursements are made appropriately
• Ensures files are properly documented and labeled
• Audits files for compliance, proactive claim handling, proper transference of claims, and appropriate outcomes
• Oversees and monitors the workload and performance of the team
• Guides team through complex work issues and answers questions
• Collaborates with team members to establish performance goals and monitors status
• Conducts performance reviews and provides coaching
• Interviews, hires, and recommends salary adjustments for team members
• Resolves disciplinary issues, reviews results, actions plans, and progress
• Develops team expertise and assists with succession planning, including identifying talent and implementing development plans for critical positions.
• Supports diversity, equity, and inclusion initiatives
• Fosters an innovative culture, including supporting new ideas and providing guidance on potential changes
• Encourages team to maintain all necessary licensing and designation requirements, including continuing education credits
• Develops and fosters excellent internal and external customer relations with workers’ compensation team, agents, customers, and other EMC team members
• Monitors customer service metrics and ensures customer experience levels are met
• Monitors proper jurisdictional handling and ensures collaboration with MO claims representatives regarding adherence with jurisdictional state procedures
• Communicates with agents proactively and anticipates agents’ and insureds’ needs
• Collaborates and communicates with management on trends, opportunities, and results, and provides recommendations to ensure EMC stays in line with the industry
  
  

Education & Experience

• Bachelor’s degree or equivalent relevant experience
• Five years of experience in workers compensation claims adjusting or related experience
• Attainment of all applicable state licenses as appropriate
• Prior leadership experience preferred
• Insurance designations, such as INS, AIC, and CPCU preferred
  
  

Knowledge, Skills And Abilities

• Excellent understanding and application of workers compensation loss claims techniques and a current knowledge of worker’s compensation estimation practices and workers compensation claims techniques
• Excellent knowledge of insurance terms and coverages in commercial lines
• Strong leadership qualities with the ability to motivate staff
• Excellent knowledge of computers and claims systems
• Excellent organizational, written and verbal communication skills
• Excellent ability to gather and analyze a variety of data points to appropriately triage claims handling
• Advanced investigative and problem-solving abilities
  
  

Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $82,757.51 - $106,263.54. The hiring range for other locations may vary.

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

All of our locations are tobacco free including in company vehicles.