Claims Team Lead - Litigation at The Judge Group Inc. in Ontario, California

Job Description:

Location: Ontario, CA

Salary: $30.00 USD Hourly - $45.00 USD Hourly

Description: Our client is currently seeking a Claims Team Lead - Litigation in Ontario, CA


This job will have the following responsibilities:

• Maintain contact with team via Microsoft Teams and phone calls for teambuilding and to provide assistance


• Approve overlimit payments process according to procedure


• Review and approve new claim determinations and provide initial directions as to whether to delay, deny, accept


• Review and approve litigation referrals and investigation referrals


• Review mail of your team, provide direction as needed


• Monitor for hearing dates and need for settlement authority requests or staffing of legal issues as they arise with examiner, DA, Director (if needed), County Representative (if needed)


• Ensure team meets their monthly #'s for core duties (reports are sent to assist with this)


• Review and ensure Medata suspended payments (bill review payments pending approval by examiner) are reviewed/processed by examiners


• Review and approve benefit notices prepared by examiners to ensure accuracy prior to mailing


• Review and approve benefits payments that exceed examiner's level and ensure appropriate documentation and paperwork is attached to the claim to support payment


• Ensure claim coding is accurate and required fields are updated


• Respond to email inquiries and phone calls to assist our customers


• Review claims for supervisor direction every 90 days or sooner depending on need


• Maintain diary on all claims with emphasis on lost time claims/and delays

Requirements:

• County of Los Angeles experience preferred


• Hybrid 2 days in office (flexible)


• 10 years of experience in workers compensation.


• Self insurance certificate mandatory.

Contact: r.singh@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com Apply Now