Claims Quality Audit Supervisor jobs in Riverside, CA

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of claims department and of CorVel.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Supervises claims staff in their day-to-day operations
• Supports Claims Manager in staff recruitment, interviews and training of new staff on procedures and job-related functions
• Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements
• Assures peak performance of the team through continued training and coaching, coupled with regular performance evaluations and recommends merit activity, subject to manager’s approval
• Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions
• Functions as liaison, suggesting and implementing final resolution for clients and employees regarding claim-specific, procedural or special requests
• Adheres to HIPPA regulations, policies, and procedures
• Requires regular and consistent attendance
• Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
• Adheres to all company policies, best practices and procedures
• Additional projects and duties as assigned

KNOWLEDGE & SKILLS:

• Excellent written and verbal communication skills
• Ability to assist team members to develop knowledge and understanding of claims practice
• Participate in Customer Claim Reviews and Presentations
• Effective quantitative, analytical and interpretive skills
• Strong leadership, management and motivational skills
• Demonstrated, Strong Customer Service Skills
• Ability to travel overnight and attend meetings if required
• Ability to remain poised in stressful situations and communicate diplomatically via telephone, computer, fax, correspondence, etc
• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
• Strong interpersonal, time management and organizational skills
• Ability to work both independently and within a team environment
• Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation

EDUCATION & EXPERIENCE:

• Bachelor's degree or a combination of education and related experience
• Demonstrated Public Speaking Skills
• Minimum of 5 years’ experience handling claims
• Knowledge of WC required
• Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel
• Self-Insured Certificate preferred
• State Certification as an experienced Examiner

PAY RANGE: 

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time. 

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process. 

Pay Range:  $65,450 – $108,911 

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management 

ABOUT CORVEL

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.