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Assistant Unit Supervisor California Workers' Compensation
at Sedgwick CMS in California
Assistant Unit Supervisor California Workers' Compensation
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To manage a reduced caseload of complex claims and maintain appropriate diaries on assigned files; to manage denials of assigned unit members; to advise unit manager of urgent cases/issues for review; to assist unit manager with developing and analyzing reports, account trends and action plans; to assist with preparation and development of unit education program, unit member performance documentation, performance appraisals, account contact information and customer service relationships with client; and to assign new cases in absence of unit manager.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Manages a reduced caseload of complex claims.
Assigns new cases in the absence of unit manager.
Maintains appropriate diaries on assigned files.
Acts as mentor/coach for unit members.
Manages denials of assigned unit members.
Advises business unit manager of urgent issues and of problems/issues for review.
Assists business unit manager in developing and analyzing reports on case manager and/or account trends.
Assists in developing action plans to address adverse trends identified.
Assists in developing and implementing a unit education/training program.
Provides performance documentation on unit members assigned.
Assists in preparing and conducting performance appraisals.
Assists in developing account contact information and maintaining account records.
Assists in maintaining sound customer service relationships with various accounts, including attendance as necessary at meetings on-or off-site.
Assists in ensuring claims files are coded correctly and adequate file and activity documentation by claims examiners.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred.
Experience
Five (5) years claims management experience required. Supervisory experience preferred.
Skills & Knowledge
Thorough knowledge of claims management procedures and processing
Knowledge of ERISA regulations; required offsets and deductions; disability and medical management practices; and Social Security application procedures may be required for some units
Good technical knowledge of claims management
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a back ground credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
REQUIREMENTS:
Must have California Self-Insurers Certificate (SIP) or AB1262 California Experienced Examiner Designation or currently meet the requirements for designation under AB1262. WCCA, WCCP preferred.
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/18671013
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To manage a reduced caseload of complex claims and maintain appropriate diaries on assigned files; to manage denials of assigned unit members; to advise unit manager of urgent cases/issues for review; to assist unit manager with developing and analyzing reports, account trends and action plans; to assist with preparation and development of unit education program, unit member performance documentation, performance appraisals, account contact information and customer service relationships with client; and to assign new cases in absence of unit manager.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Manages a reduced caseload of complex claims.
Assigns new cases in the absence of unit manager.
Maintains appropriate diaries on assigned files.
Acts as mentor/coach for unit members.
Manages denials of assigned unit members.
Advises business unit manager of urgent issues and of problems/issues for review.
Assists business unit manager in developing and analyzing reports on case manager and/or account trends.
Assists in developing action plans to address adverse trends identified.
Assists in developing and implementing a unit education/training program.
Provides performance documentation on unit members assigned.
Assists in preparing and conducting performance appraisals.
Assists in developing account contact information and maintaining account records.
Assists in maintaining sound customer service relationships with various accounts, including attendance as necessary at meetings on-or off-site.
Assists in ensuring claims files are coded correctly and adequate file and activity documentation by claims examiners.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred.
Experience
Five (5) years claims management experience required. Supervisory experience preferred.
Skills & Knowledge
Thorough knowledge of claims management procedures and processing
Knowledge of ERISA regulations; required offsets and deductions; disability and medical management practices; and Social Security application procedures may be required for some units
Good technical knowledge of claims management
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a back ground credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
REQUIREMENTS:
Must have California Self-Insurers Certificate (SIP) or AB1262 California Experienced Examiner Designation or currently meet the requirements for designation under AB1262. WCCA, WCCP preferred.
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/18671013
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Published on Feb 18, 2011
Viewed: 340 times
Viewed: 340 times
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