The employer’s workers’ compensation coordinator who deals with the claims adjusters on a regular basis usually has a decent understanding of the work done by the adjuster. The work comp coordinator knows the adjuster has a claims supervisor as the adjuster will from time to time state they discussed this or that claim with the supervisor, or that they have consulted with the supervisor for claim settlement authority. Beyond this, most employers don’t know exactly who the workers compensation claims supervisor is or what he does.
Duties & Responsibilities of the Workers Compensation Claims Supervisor
The duties and responsibilities of the workers compensation claims supervisor are as varied as those of the adjuster, plus often include addition task and responsibilities related to management. While no two insurers or two third party administrators will have the supervisor with exactly the same responsibilities, the following is a general guideline as to the duties and responsibilities of the claims supervisor.
- Providing leadership to the adjusters in the supervisor’s unit
- Interviewing and hiring new adjusters
- Reviewing and assigning new claim assignments and various task within the unit
- Organizing workflow within the unit
- Providing instructions on the initial investigation of any claim with unusual characteristics or red-flags
- Providing directions and instructions on how to handle various claim handling issues that occur during the course of claims
- Providing training as needed (based on the individual needs of each adjuster)
- Reviewing the work product of the adjusters to verify compliance with all Best Practices
- Monitoring the work load of each adjuster to balance out the work load and to prevent overloading of the adjusters with work
- Monitoring the development on large or complex claims
- Providing directions to the adjusters on jurisdictional requirements
- Leading round table discussions on complex claims
- Overseeing the exchange of computer data with clients, state government and defense counsel
- Completing regularly scheduled reviews of litigated claims
- Analyzing data on new claims, age of claims, average payments and claim closings
- Compiling performance reports for upper management
- Conveying to management all issues that deserve management’s attention
- Conveying to adjusters new information from management or clients
- Identifying performance gaps and assisting adjusters with performance improvement
- Completing performance reviews for each adjuster
- Maintaining rapport and acting as a liaison with clients
- Interfacing with clients on large claims, difficult claims, etc., to keep clients apprised of the claim developments
- Championing the company’s quality control program / Best Practices
- Verifying all adjusters meet state continuing education and licensing requirements
- Verifying all adjusters complete all company required training courses, classes and seminars
The workers compensation claims supervisor normally has years of experience as an adjuster and knows the problems and pitfalls the adjusters encounter. A lot of the job of the workers’ compensation claims supervisor is foreseeing the problems that will be incurred and preventing them from happening.
Get Acquainted with Your Claims Supervisor
For a person to be a successful claims supervisor, strong communications and time management skills are essential. Other skills needed include management skills, analytical skills, negotiation skills, leadership skills and motivational skills.
If you are not already acquainted with the workers compensation claims supervisor of your dedicated adjuster(s) or designated adjuster, take the time to introduce yourself and get to know this person. Most claims supervisors enjoy talking with their clients and can be a great problem solver whenever there is an issue with a claim or with an adjuster. By building a connection and rapport with the claims supervisor, you will have fewer claim issues to deal with. When you do have a claim issue that needs to be addressed, the claims supervisor will get it resolved for you.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: [email protected].
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.
