Workers Compensation Claims Supervisor

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🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $95k - $105k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 2%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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TRISTAR Insurance Group

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1987

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

TRISTAR Insurance Group is a national third-party administrator (TPA) that provides insurance administration and risk management services to employers, insurers and public entities. Its solutions include property & casualty, workers' compensation, general and auto liability, managed care (bill review, case management, utilization review, nurse triage, pharmacy benefit management), absence and disability management, employee group benefits administration, and risk control and workplace safety services. TRISTAR emphasizes collaborative, technology-enabled and tailored services to transform risk into opportunity for its clients.

📋 Description

• Oversee daily operations of a workers’ compensation claims unit under minimal supervision • Ensure timely, accurate, and high-quality claims handling in compliance with state laws, client requirements, and company policies • Directly supervise examiners and clerical staff, including attendance, performance evaluations, and disciplinary issues • Participate in new-hire interviewing, training, and personnel action processes • Monitor staffing needs and distribute caseloads equitably • Review and address scheduled claims issues, including initial and periodic reviews, delays, and denials • Perform file reviews for accuracy and compliance • Ensure consistent and accurate claim coding • Prepare agendas and lead team meetings • Make daily claims decisions regarding claim strategies, action plans, payments, recoveries, and reporting • Run supervisory reports to monitor performance • Review and approve reserve changes and payments within company and client guidelines • Establish and complete supervisory diaries • Prepare for claim audits, review results, and provide rebuttal feedback • Lead educational and training sessions on updated laws, policies, and procedures • Respond to claimant and vendor concerns and facilitate resolution • Evaluate vendor effectiveness and modify vendor panels as needed • Ensure staff follow client service instructions and state reporting requirements • Provide claims-handling coverage during absences and vacancies • Prepare, evaluate, and analyze monthly client reports • Coordinate and support internal and external audits • Participate in client file and claim reviews and address action items • Partner with corporate office and sales and service teams on RFPs and client service issues • Adhere to TRISTAR’s Best Practices • Perform other duties as assigned

🎯 Requirements

• High School Diploma or GED listed in the posting • Five (5) plus years related experience, or equivalent combination of education and experience • Strong technical knowledge of multi-state workers’ compensation laws, regulations, and medical terminology • Ability to maintain a claims diary system, prioritize work, and meet strict deadlines • Strong analytical and problem-solving skills • Proficiency in Microsoft Word and Excel • Excellent written and verbal communication skills, including explaining technical claims information clearly to claimants, clients, and staff • Ability to supervise, coach, and develop employees with varying levels of experience and technical ability • Strong interpersonal skills and ability to maintain effective working relationships • Ability to manage competing priorities and remain effective under pressure • Ability to model a positive, professional attitude to direct reports • Ability to respond promptly to client requests and service needs • Certifications and/or licenses as required by State regulation

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