Highview National Insurance CompanyRockland County, NY, US
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Highview National Insurance CompanyRockland County, NY, US
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[job_card.full_time]
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Worker’s compensation insurance is a headache.
We make it simple, smooth, and stress free.
Join us in redefining workers’ comp.
Job Summary :
The Workers' Compensation Claims Supervisor oversees a team of claims adjusters responsible for managing workers' compensation claims.
This role ensures compliance with jurisdictional regulations, adherence to best practices, and attainment of performance targets.
The Supervisor is responsible for technical guidance, training, quality assurance, and operational efficiency.
Please note :
This job description outlines general duties and expectations and is not intended to be exhaustive.
Duties may change based on business needs.
Essential Job Functions :
Supervise daily activities of assigned workers' compensation claims adjusters.
Triage new files to ensure assignments are appropriate.
Review first diary within 7 days of assignment for coverage, compensability, damages, compliance, reserves, and plan of action.
Monitor caseload distribution monthly and ensure appropriate workloads.
Use appropriate metrics for Return to Work, New / Reopened claims, claim closures per month, penalties, and timely contact.
Review claim files for quality assurance, reserve accuracy, and compliance.
Conduct quality assurance audits (5-7 claims per adjuster monthly) and reserve accuracy audits per jurisdiction.
Ensure all state forms are filed correctly and timely with zero penalties.
Provide coaching, mentoring, and technical guidance to adjusters through monthly one-on-ones.
Ensure timely and appropriate reserving and settlement authority adherence.
Facilitate regular file audits and roundtables on complex or high-exposure claims.
Coordinate training for new hires and continuing education for the team.
Develop training modules and onboarding tasks for new adjusters.
Serve as an escalation point for complex or litigated claims.
Authority level :
$50,000 for reserve and settlement; roundtable claims with managers for amounts ≥ $100,000; settlements ≥ $50,000.
Communicate with insured and brokers on claims above $25,000 and work with the account manager to set up claim reviews.
Collaborate with internal departments (Legal, Compliance, Risk Management).
Generate reports for management including performance metrics and trends.
Conduct monthly one-on-ones with the manager to review team metrics, audit scores, trends, and staffing.
Identify process improvements to enhance claims efficiency and outcomes.
Maintain knowledge of applicable jurisdictional regulations (e.g., NY, NJ, PA).
Seek training opportunities with vendors and law firms to enhance knowledge and performance.
Required Skills / Abilities :
Excellent oral and written communication skills—able to convey complex information effectively.
Detail-oriented with a high accuracy rate, ensuring precision in claim processing.
Strong critical thinking and problem-solving skills to assess claims efficiently and make informed decisions.
Flexible and tech-savvy, comfortable navigating various software tools and adapting to new processes.
Highly adaptable, able to adjust to evolving laws and industry changes with ease.
Thrives in a dynamic environment—willing to embrace change and contribute to continuous improvement.
Self-motivated with excellent time management, capable of handling multiple priorities effectively.
Education and Experience :
Bachelor’s degree preferred or equivalent work experience.
Minimum 5 years of experience in workers' compensation claims handling.
Prior leadership or supervisory experience 1-3 years preferred.
Strong understanding of state-specific WC laws and regulations.
Excellent communication, organization, and problem-solving skills.
Proficient in claims management systems and Microsoft Office.
Ability to use metrics as a tool to manage performance.
Physical Requirements :
Prolonged periods sitting at a desk and working on a computer.
Prolonged periods of standing, walking, and / or sitting and reaching with hands and arms.
Must be able to lift 10 pounds at a time.
Additional Requirements :
Due to the nature of our business, and urgency of our clients' needs, you may be required to participate in the company’s on-call program and work on holidays / weekends according to the on-call schedule.
Additional Details :
This is a full-time in office position in Rockland County, NY.
We offer a competitive salary ranging from $110-165k with generous PTO and Benefits.
We are an Equal Opportunity Employer We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation.
We intend that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.