workers' compensation claims supervisor

TEEMA Group

<div><h3 class="jobSectionHeader">Role Summary</h3>
The Workers&rsquo; Compensation Claims Supervisor is a key leadership role responsible for guiding and overseeing a high-performing claims team in a fast-paced, compliance-focused environment. This position offers the opportunity to combine deep technical expertise in Texas workers&rsquo; compensation with hands-on leadership, mentorship, and client engagement. The Supervisor ensures accurate claims handling, regulatory compliance, exceptional service delivery, and continuous professional development of staff, while serving as a trusted resource for clients and internal partners.
This is an ideal opportunity for an experienced claims leader who thrives in an in-office setting, values accountability and collaboration, and enjoys driving both operational excellence and team success.
<h3 class="jobSectionHeader">Key Duties &amp; Responsibilities</h3><ul><li>
Supervise, mentor, and support Claims Examiners, Claims Assistants, and administrative staff</li><li>
Monitor attendance, performance, evaluations, and address disciplinary matters as needed</li><li>
Review claims activity, including initial reviews, ongoing case management, delays, and denials</li><li>
Approve reserve changes up to $250,000 and payments up to $10,000 in accordance with internal guidelines</li><li>
Conduct comprehensive file reviews to ensure compliance with Texas workers&rsquo; compensation laws, client requirements, and internal procedures</li><li>
Coordinate and lead training sessions related to regulatory updates, internal policies, and best practices</li><li>
Ensure caseloads are appropriately staffed, balanced, and managed efficiently</li><li>
Approve priority payments and sign checks as required</li><li>
Respond professionally and promptly to claimant, vendor, and client inquiries or concerns</li><li>
Monitor vendor performance and recommend or implement panel adjustments as necessary</li><li>
Ensure all client servicing instructions are consistently followed</li><li>
Provide coverage for claims examiners during absences or vacancies</li><li>
Prepare, review, and evaluate monthly client reports</li><li>
Facilitate and participate in internal and external audits</li><li>
Conduct and document educational and training sessions for internal teams and external stakeholders</li><li>
Attend client file reviews and meetings as needed</li><li>
Collaborate with leadership and sales/service teams on RFPs and client service initiatives</li><li>
Adhere to Supervisor Best Practice Guidelines</li><li>
Perform additional duties as assigned to support operational and organizational goals</li></ul><h3 class="jobSectionHeader">
Required Qualifications</h3><ul><li>
High School Diploma or GED</li><li>
Minimum of 5 years of supervisory experience within workers&rsquo; compensation claims</li><li>
Active Texas Adjuster&rsquo;s License</li><li>
Strong working knowledge of Texas workers&rsquo; compensation statutes and regulations</li><li>
Solid understanding of medical terminology</li><li>
Proven experience supervising claims staff in a high-volume environment</li></ul><h3 class="jobSectionHeader">
Desired Qualifications</h3><ul><li>
Bachelor&rsquo;s degree in a related field</li><li>
Experience handling Texas public entity and school district claims (highly preferred)</li><li>
Strong analytical and problem-solving capabilities</li><li>
Ability to manage diary systems, prioritize workload, and meet strict deadlines</li><li>
Excellent written and verbal communication skills</li><li>
Ability to clearly explain complex claims information to claimants, clients, and staff</li><li>
Proficiency in Microsoft Word and Excel</li><li>
Demonstrated ability to manage and mentor employees with varying experience levels</li><li>
Strong interpersonal, leadership, and coaching skills</li><li>
Ability to manage stress, multitask effectively, and maintain focus in a deadline-driven environment</li><li>
Positive, professional attitude with a strong sense of urgency and accountability</li></ul><h3 class="jobSectionHeader">
About the Organization</h3>
This opportunity is with a well-established organization specializing in workers&rsquo; compensation and claims administration services. The organization is committed to regulatory excellence, client satisfaction, and fostering a collaborative, professional work environment that supports growth, leadership development, and long-term career success.
<h3 class="jobSectionHeader">Location &amp; Work Type</h3><ul><li>
Location: Irving, Texas</li><li>
Work Type: On-site, in-office role</li></ul>
#Workwolf</div>

Workers’ Compensation Claims Supervisor

State of Ohio

<div><div>What Our Employees Have to Say: 
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:<ul><li>
BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.</li><li>
I have worked at several state agencies and BWC is the best place to work.</li><li>
Best place to work in the state and with a sense of family and support.</li> 
<li>
I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.</li><li>
I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC. 
If you are interested in helping BWC grow, please</li></ul>
BWC&rsquo;s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC&rsquo;s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.
What You'll Be Doing: 
Under general direction, you will supervise one claims service team consisting of multiple claims specialists &amp; multiple medical/rehab staff (e.g. Industrial Rehab Nurse, Rehab Case Management Specialist) in managing lost time compensation claims.<ul><li>
Supervise and Lead Team-Oversee one claims service team consisting of multiple claims specialists, ensuring effective management of lost-time compensation claims.</li><li>
Develop and Implement Guidelines-Create and enforce new claims handling procedures to maintain compliance with state, federal, and BWC laws, rules, and regulations.</li><li>
Monitor Quality and Productivity-Review case assignments, monitor accuracy and timeliness, and utilize management reports to track pending cases and performance metrics.</li><li>
Identify and Resolve Issues-Address problem areas such as incorrect award calculations and insufficient documentation; recommend corrective actions.</li><li>
Ensure Documentation and Compliance-Verify that all necessary documentation is obtained for hearings and identify claims requiring vocational intervention based on injury severity and claimant history.</li><li>
Staff Development and Performance Management-Review and approve performance evaluations, recommend training or disciplinary actions, and participate in staff selection, training, and promotion processes.</li><li>
Effective Communication and Relationship Building- Ability to clearly convey expectations, provide constructive feedback, and build positive relationships with team members, injured workers, employers, and medical providers to foster collaboration and trust.</li></ul>
Why Work for the State of Ohio
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
<ul>
<li>Medical Coverage</li>
<li>Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period</li>
<li>Paid time off, including vacation, personal, sick leave and 11 paid holidays per year</li>
<li>Childbirth, Adoption, and Foster Care leave</li>
<li>Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)</li>
<li>Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) &amp; Optional Deferred Compensation (Ohio Deferred Compensation)</li>
</ul>
<ul><li>Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.</li></ul>
Qualifications
To Qualify, You Must Clearly Demonstrate: 
Required Experience and/or Education:<ul><li>
36 mos. exp. managing medical-only &amp;/or lost-time claims, serving as primary decision maker to include making initial determination of claim, having overall responsibility &amp; accountability of claim &amp; management of claim to desired outcome.</li><li>
Or 36 mos. trg. or 36 mos. exp. in providing rehabilitation &amp;/or medical management expertise in managing claims (e.g., develop return to work plans AND provide medical opinion; recommend, monitor &amp;/or review medical treatment &amp; determinations; provide job development training or career counseling enabling injured workers to return to work force).</li><li>
Or 24 mos. trg. or 24 mos. exp. in private insurance organization as claims representative, nurse or rehabilitation specialist AND 12 mos. trg. or 12 mos. exp. providing work direction to claims processing staff.</li><li>
Or completion of undergraduate core program in business administration, public administration, human resources, finance, economics, nursing, social work, human service field (e.g., rehabilitation counseling) or related field AND 12 mos. exp. in providing rehabilitation &amp;/or medical expertise in managing workers' compensation claim (e.g., develop return to work plans; provide medical opinion; recommend, monitor &amp; review medical treatment &amp; determinations; provide job development training or career counseling enabling injured workers to return to work force), or 12 mos. exp. managing workers' compensation lost-time claims &amp;/or medical-only claims serving as primary decision maker to include making initial determination of claim, having overall claim responsibility &amp; accountability of claim &amp; management of claim to desired outcome, or 12 mos. exp. supervising lower-level claims staff in managing medical only claims, or 12 mos. exp. in supervisory level position within Ohio Bureau Of Workers' Compensation which involved telephoned, in-person &amp;/or written contact with providers, claimants, employers, public officials, attorneys &amp;/or general public to provide information &amp; answer inquiries concerning various operations, services &amp;/or policies &amp; procedures of agency.</li><li>
Or 36 mos. exp. in supervisory-level position within Ohio Bureau Of Workers' Compensation, 24 mos. of which involved telephoned, in-person &amp;/or written contact with providers, claimants, employers, public officials, attorneys &amp;/or general public to provide information &amp; answer inquiries concerning various operations, services &amp;/or policies &amp; procedures of agency.</li><li>
Or equivalent of Minimum Class Qualifications For Employment noted above. 
 
Job Skills: Claims Examination</li></ul>
Major Worker Characteristics: 
Knowledge of management, labor relations, employee training &amp; development, supervision (direct), interviewing, public relations, service office practices &amp; procedures*, agency policies &amp; procedures*, state laws related to BWC claims &amp; eligibility criteria &amp; processing of workers comp claims*. 
Ability to deal with problems involving few variables within familiar context; define problems, collect data, establish facts &amp; draw valid conclusions; calculate fractions, decimals &amp; percentages; use proper research methods in gathering data &amp; make impartial decisions; check data against records for accuracy; operate VDT &amp; PC; read &amp; understand medical reference manuals; prepare meaningful, concise &amp; accurate reports; gather collate &amp; classify information about data, people or things; proofread technical materials &amp; make corrections; handle sensitive inquiries from &amp; contacts with officials &amp; general public; comprehend computer generated reports, oral &amp; written business communications.
(*) developed after employment.
Supplemental Information
EEO &amp; ADA Statement: 
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order. 
The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request reasonable accommodations related to disability, pregnancy, or religion, please contact the ADA mailbox BWCADA@bwc.ohio.gov. 
 
BWC OCSEA Selection Rights: 
This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement. BWC bargaining unit members have selection rights before non-bargaining unit members. All other applications will only be considered if an internal bargaining unit applicant is not selected for this position. 
 
Salary Information: 
Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months, assuming job performance is acceptable. Thereafter, an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service. 
 
Transportation: 
Position may require travel; therefore, persons occupying this position must be able to provide own transportation &amp;/or legally operate a state-owned vehicle. 
 
Educational Transcripts: 
For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed. 
 
All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted. 
 
Background Check: 
Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.
ADA Statement
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
Drug-Free Workplace
The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.</div></div>

Canton - Workers' Compensation Claims Supervisor- PN: 20077435

Texas Comptroller of Public Accounts

<div><div>SORM | Claims Supervisor | 26-0436 (00057518)<div>
</div>
Organization: STATE OFFICE OF RISK MANAGEMENT<div>
</div></div><div>
Primary Location: Texas-Austin<div>
</div>
Work Locations: Office of Risk Management 300 W. 15Th St 6Th Floor Austin 78701<div></div><div> 
</div></div><div>
Job: Management<div>
</div></div><div>
Employee Status: Regular<div>
</div></div><div>
Schedule: Full-time<div>
</div>
Standard Hours Per Week: 40.00<div>
</div></div><div>
State Job Code: 1586<div>
</div></div><div>
Salary Admin Plan: B<div>
</div></div><div>
Grade: 23<div>
</div></div><div>
Salary (Pay Basis): 6,890.62 - 6,890.62 (Monthly)<div>
</div></div><div>
Number of Openings: 1<div>
</div></div><div>
Overtime Status: Exempt<div>
</div></div><div>
Job Posting: Apr 9, 2026, 2:08:07 PM<div>
</div></div><div>
Closing Date: Ongoing<div>
</div></div><div>
Description<div></div> 
GENERAL DESCRIPTION 
Work includes active participation in establishing Claims Operations Department goals and objectives; developing department guidelines, procedures, policies, rules, and regulations; developing schedules, priorities, and standards for achieving department goals; evaluating department activities; and coordinating department activities. Plans, assigns, and supervises the work of others. 
ESSENTIAL POSITION FUNCTIONS<ul><li>
Oversees the work of assigned unit within Claims Operations Department</li><li>
Participates in the preparation of program management and productivity reports and studies</li><li>
Confers with staff on department issues and problems to identify and implement solutions</li><li>
Plans, implements, coordinates, monitors, and evaluates programs</li><li>
Participates in establishes department goals and objectives; and develops and approves schedules, priorities, and standards for achieving goals</li><li>
Participates in the development of department goals and objectives evaluation activities</li><li>
Provides technical assistance in a department area</li><li>
Plans, assigns, and supervises the work of others</li><li>
Communicates openly and honestly with colleagues and customers</li><li>
Takes personal responsibility for the quality and content of assigned units&rsquo; work product</li><li>
Prioritizes unit and individual workload to ensure deadlines are met and productivity maximized</li><li>
Ensure equal collaboration and contribution among unit and claims department</li><li>
Development of claims adjusters, explaining claims processes, deadlines and overall claims handling in an understandable manner.</li><li>
Maintain and retain claims staff, along with working to keep team morale at a positive state</li><li>
Review claims from adjusters on the team to ensure quality of claims handling.</li><li>
Performs related work as assigned</li><li>
Maintains relevant knowledge necessary to perform essential job functions</li><li>
Attends work regularly in compliance with agreed-upon work schedule</li><li>
Ensures security and confidentiality of sensitive and/or protected information</li><li>
Complies with all agency policies and procedures, including those pertaining to ethics and integrity</li></ul><div>
</div></div><div>
Qualifications<div></div> 
MINIMUM QUALIFICATIONS<ul><li>
Education: Graduation from high school or equivalent</li><li>
Experience: Five years full-time reviewing, adjusting, or processing workers&rsquo; compensation claims experience</li><li>
Licensed to adjuster workers&rsquo; compensation claims in Texas {License will be verified pre-employment}</li><li>
Knowledge of Division of Workers&rsquo; Compensation appeals process</li><li>
Knowledge of medical terminology</li><li>
Knowledge of Texas Workers&rsquo; Compensation law and claims administration</li><li>
Skill in working under pressure and meeting deadlines</li><li>
Skill in working effectively with a diverse of customers</li><li>
Skill in handling multiple tasks, prioritizing, and meeting deadlines</li><li>
Skill in effective oral and written communication [Writing sample required at time of application and administered at the time of interview]</li><li>
Ability to be an independent worker within a team environment</li><li>
Skill in exercising sound judgment and effective decision making</li><li>
Ability to make timely, informed decisions that take into account the facts, goals, constraints, and risks</li><li>
Ability to interpret and appropriately apply complex rulings regarding Texas Workers&rsquo; Compensation law and claims administration</li><li>
Ability to receive and respond positively to constructive feedback</li><li>
Ability to work cooperatively with others in a professional office environment</li><li>
Ability to provide excellent customer service</li><li>
Ability to provide a positive work environment for claims staff</li><li>
Ability to complete assignments with attention to detail and accuracy</li><li>
Ability to arrange for personal transportation for business-related travel</li><li>
Ability to work more than 40 hours as needed and in compliance with the FLSA</li><li>
Ability to lift and relocate 30 lbs.</li><li>
Ability to travel (including overnight travel) up to 5%</li></ul> 
PREFERRED QUALIFICATIONS<ul><li>
Education: Graduation from an accredited four-year college or university</li><li>
Management experience</li><li>
Advanced knowledge of medical and pharmaceutical terminology</li><li>
Advanced knowledge of general accepted medical procedures</li><li>
Associate in Claims or other related insurance certification</li></ul>
TO APPLY 
All applications for employment with the State Office of Risk Management must be submitted electronically through www.WorkInTexas.com. A State of Texas application in WorkInTexas (WIT) must be completed to be considered OR Submit a State of Texas Application for Employment to: Attn: Elaina Middleton, State Office of Risk Management, P.O. Box 13777, Austin, TX 78711-3777. Military Crosswalk information can be accessed at
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_ProgramManagement.pdf
THE SORM IS AN EQUAL OPPORTUNITY EMPLOYER</div></div>

SORM | Claims Supervisor | 26-0436

CCMSI

Overview: Position Title: CA Work Comp Supervisor Location: Irvine, California Schedule: Hybrid - 8am to 4:30pm PST Salary Range: $110,000 - $115,000 Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don&rsquo;t just process claims&mdash;we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work&reg;, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are seeking an experienced Workers&rsquo; Compensation Claim Supervisor with indemnity experience to lead a single‑account team in our Irvine, California office. This is a hybrid position, and an in‑office presence is required to effectively coach, mentor, and support the team. The Supervisor will oversee a typically 4-5 Examiners and 1 Assistant, guiding the full investigation, evaluation, and resolution of California Workers&rsquo; Compensation claims. This role ensures timely and accurate claim handling, compliance with all CA requirements, and adherence to CCMSI&rsquo;s Corporate Claim Standards. It also serves as a strong developmental path for advancement into management. Responsibilities: Supervise and direct daily workers&rsquo; compensation claim activity for assigned accounts, ensuring compliance with corporate claim standards, client-specific instructions, and California workers&rsquo; compensation laws. Review, assign, and oversee claim files to ensure timely, accurate, and compliant handling by claim staff. Directly handle and provide oversight of complex, litigated, and high-exposure workers&rsquo; compensation claims. Establish, review, and authorize claim reserves within designated authority levels in accordance with best practices and regulatory requirements. Evaluate medical, legal, indemnity, and expense invoices to ensure appropriateness, necessity, and claim-relatedness; negotiate disputed charges to resolution. Authorize and process workers&rsquo; compensation payments within established authority using claim management and payment systems. Negotiate settlements in compliance with corporate standards, client instructions, and applicable California regulations. Guide and support claim staff in vendor selection and management, including legal counsel, medical case management, surveillance, and other external resources. Provide coaching, training, performance feedback, and professional development support to assigned claim staff. Maintain review oversight of claim diaries and documentation to ensure accuracy, timeliness, and audit readiness. Ensure adherence to corporate claim handling standards, internal controls, and special client requirements at all times. Qualifications: Required 10+ years of Workers&rsquo; Compensation claims handling experience, including full claim investigation, evaluation, and resolution. Demonstrated ability to lead and oversee adjusters in a fast-paced, compliance-driven environment while maintaining quality and service standards. Strong understanding of California Workers&rsquo; Compensation regulations, claim practices, and compliance requirements. Active SIP is required Effective communication skills with the ability to engage professionally with adjusters, clients, and internal partners. Working knowledge of entry- and mid-level WC adjusting roles and workflows. Reliable attendance during established client service hours for the Irvine branch location. Nice to Have Prior supervisory or people-lead experience within Workers&rsquo; Compensation. Bachelor&rsquo;s degree or equivalent combination of education and experience. Industry certifications such as [Certification &ndash; e.g., SIP, WCP, AIC]. AIC, CPCU, or ARM preferred Bilingual (Spanish) proficiency &mdash; highly valued for communicating with claimants, employers, or vendors, but not required. Why You&rsquo;ll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling &ndash; thorough investigations, strong documentation, well-supported decisions Compliance &amp; audit performance &ndash; adherence to jurisdictional and client standards Timeliness &amp; accuracy &ndash; purposeful file movement and dependable execution Client partnership &ndash; proactive communication and strong follow-through Professional judgment &ndash; owning outcomes and solving problems with integrity Cultural alignment &ndash; believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation &amp; Compliance Compensation: The posted salary reflects CCMSI&rsquo;s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. Visa Sponsorship: CCMSI is unable to provide visa sponsorship for this position. ADA Accommodations: Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Equal Opportunity Employer: CCMSI is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Our Core Values At CCMSI, we believe in doing what&rsquo;s right&mdash;for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don&rsquo;t just work together&mdash;we grow together. If that sounds like your kind of workplace, we&rsquo;d love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #TPA #InsuranceCareers#WorkersCompensation #WorkersComp #WCClaims #ClaimSupervisor #ClaimsLeadership #ClaimsManagement #InsuranceCareers #InsuranceJobs #TPACareers #CAWorkersComp #CaliforniaJobs #IrvineJobs #SoCalJobs #LeadershipOpportunity #JoinOurTeam #HiringNow #IND123 #LI-Hybrid

CA Work Comp Supervisor

Sedgwick

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Team Lead - Workers Compensation | Rancho Cordova, CA
<div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</div><div><ul><li>Apply your complex claims knowledge and experience in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</li></ul>ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
OFFICE LOCATIONS
 
Rancho Cordova, CA (Hybrid)
</div>PRIMARY PURPOSE: To supervise the operation of workers compensation examiners for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
<ul><li>Supervises a team of examiners; may delegate some duties to others within the unit.
</li><li>Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
</li><li>Provides technical/jurisdictional direction to examiner reports on claims adjudication.
</li><li>Compiles reviews and analyzes management reports and takes appropriate action.
</li><li>Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
</li><li>Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
</li><li>Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
</li><li>Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
</li><li>Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
</li><li>Assures that direct reports are properly licensed in the jurisdictions serviced.
</li><li>Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
</li></ul>SUPERVISORY RESPONSIBILITIES
<ul><li>Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
</li><li>Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
</li><li>Provides support, guidance, leadership and motivation to promote maximum performance.
</li></ul>QUALIFICATIONS
Education &amp; Licensing
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
Experience
Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
Licensing / Jurisdiction Knowledge: California workers compensation claims handling experience | SIP Certified
TAKING CARE OF YOU
<ul><li>Flexible work schedule
</li><li>Career development
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one
</li></ul>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $100,000-$115,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
#Claims #Supervisor #Hybrid #LI-Hybrid #LI-Remote #LI-AM
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles&rsquo; Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Claims Team Lead - Workers Compensation | Rancho Cordova, CA

Cala Sourcing Solutions LLC

<div><h2 class="jobSectionHeader">Workers&rsquo; Compensation Claims Adjuster (Level II or III) &ndash; Hawaii</h2>
Location: Kapolei, HI (Hybrid for local candidates | Remote for candidates outside the island but must be in Hawaii)<h3 class="jobSectionHeader">
Position Summary</h3>
A leading Third Party Administrator is seeking an experienced Workers&rsquo; Compensation Claims Adjuster to manage a diverse caseload of Hawaii workers&rsquo; compensation claims. Reporting to Claims Leadership, this role is responsible for end-to-end claim ownership&mdash;from intake and investigation through resolution&mdash;while operating within established authority levels and client guidelines.
This position involves regular collaboration with injured workers, employers, medical providers, attorneys, vendors, and internal partners. Claim complexity, litigation exposure, settlement authority, and leadership expectations will align with the Adjuster&rsquo;s level (Examiner II or Examiner III).<h3 class="jobSectionHeader">
Core Responsibilities (Examiner II &amp; III)</h3><ul><li>
Oversee a full inventory of workers&rsquo; compensation claims, including medical-only, indemnity, future medical, and litigated files</li><li>
Conduct prompt and comprehensive claim investigations; document findings thoroughly and accurately</li><li>
Evaluate compensability and administer benefits in compliance with Hawaii statutes and applicable claim-handling instructions</li><li>
Coordinate medical care, authorize treatment, and manage medical billing activity</li><li>
Serve as the primary point of contact for claimants, employers, providers, vendors, and clients</li><li>
Establish, review, and adjust claim reserves in accordance with company and client standards</li><li>
Maintain detailed claim notes, action plans, and diary entries reflecting claim strategy and progress</li><li>
Negotiate, resolve, and close claims within assigned settlement authority</li><li>
Perform regular file reviews and respond to client inquiries in a timely manner</li><li>
Identify emerging trends, risk indicators, and safety concerns; communicate insights proactively</li><li>
Utilize claims systems and internal technology to manage workload efficiently</li><li>
Comply with all internal policies, procedures, and best practices</li><li>
Complete additional duties as assigned</li></ul><h3 class="jobSectionHeader">
Advanced / Senior-Level Responsibilities (Primarily Examiner III)</h3><ul><li>
Independently manage highly complex, catastrophic, and litigated workers&rsquo; compensation claims</li><li>
Retain and collaborate with defense counsel; actively participate in hearings, mediations, and settlement negotiations</li><li>
Evaluate and pursue:<ul><li>
Subrogation opportunities</li><li>
Apportionment considerations</li><li>
Excess coverage reporting and reimbursement</li></ul></li><li>
Support regulatory compliance through audit preparation and state-required reporting</li><li>
Develop proactive claim strategies focused on timely, cost-effective resolution</li><li>
Participate in client file reviews and meetings as requested</li><li>
Provide mentoring and technical support to junior Claims Examiners</li><li>
Handle multi-jurisdictional claims when assigned</li></ul><h3 class="jobSectionHeader">
Qualifications</h3><h4 class="jobSectionHeader">
Education &amp; Experience</h4>
Claims Examiner II<ul><li>
Bachelor&rsquo;s degree in a related discipline preferred</li><li>
3+ years of workers&rsquo; compensation claims experience, or an equivalent combination of education and experience</li></ul>
Claims Examiner III<ul><li>
5+ years of progressive workers&rsquo; compensation claims experience</li><li>
Proven experience managing complex and litigated indemnity claims</li></ul><h3 class="jobSectionHeader">
Knowledge, Skills &amp; Abilities</h3><ul><li>
Strong working knowledge of workers&rsquo; compensation laws, regulations, and medical terminology</li><li>
Ability to independently assess risk, analyze complex issues, and manage claims strategically</li><li>
Clear, professional written and verbal communication skills</li><li>
Strong organizational, analytical, and time-management capabilities</li><li>
Ability to communicate effectively with diverse stakeholders at all organizational levels</li><li>
Proficiency with Microsoft Word and Excel preferred</li></ul><h3 class="jobSectionHeader">
Licensure</h3><ul><li>
Active Hawaii Workers&rsquo; Compensation Adjuster License required</li></ul>
#Workwolf</div>

Claims Supervisor - Workers Compensation

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
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Workers Compensation Claims Adjuster | Rancho Cucamonga, CA
<div><div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</div></div><div><ul><li>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</li></ul>ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
OFFICE LOCATIONS
Rancho Cucamonga, CA - Hybrid 
 
PRIMARY PURPOSE OF THE ROLE: To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Manages workers&rsquo; compensation claims, including determining compensability and benefits, developing action plans, monitoring reserve accuracy, and ensuring timely resolution in accordance with claim or client contracts.
</li></ul><ul><li>Processes and approves claim payments, coordinates return-to-work efforts, manages subrogation, and negotiates settlements.
</li><li>Communicates claim activity with claimants and clients while maintaining strong professional relationships.
</li><li>Ensures accurate claim documentation, coding, and required state and physician filings.
</li><li>May handle complex lifetime or defined-period medical claims, including utilization review treatment decisions.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 4 years of claims management experience or equivalent combination of education and experience required.
<ul><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul>Licensing / Jurisdiction Knowledge: California workers' compensation claims handling experience | SIP certified preferred
TAKING CARE OF YOU
<ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $70,000-$80,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
#claimsadjuster #claims #remote #LI-GC1 #LI-Remote
</div>Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles&rsquo; Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Workers Compensation Claims Adjuster | Rancho Cucamonga, CA

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