Assistant Claims Supervisor - TX

ATHENS POSITION DETAILS

Position Title:

Assistant Claims Supervisor - Texas

Department:

Workers’ Compensation

Reports To:

Claims Supervisor

FLSA Status:

Exempt

Job Grade:

13

Career Ladder:

Next step in progression could include Claims Supervisor

ATHENS ADMINISTRATORS

Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!

Position Summary

Athens Administrators has an immediate need for an Assistant Claims Supervisor to support our Texas Workers Compensation department. Management that lives less than 36 miles from the San Antonio office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Texas. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employees work a 37.5-hour work week with the ability to work a flex schedule with every third Monday or Friday off.

As an Assistant Claims Supervisor, you’ll play a pivotal role in collaborating with your direct supervisor to achieve exciting company goals, run insightful reports, and streamline processes for a team of Future Medical Examiners. You'll make impactful daily claims decisions, review files for accuracy, and approve payments that exceed examiner authority. Additionally, you'll ensure top-notch file handling, accurate claims coding, and meet unit closing goals. You'll be the guiding force for your team, planning, organizing, delegating workloads, supervising daily activities, providing training, and offering valuable guidance.

You'll support your supervisor in planning, organizing, delegating workloads, overseeing daily activities, providing training, and offering valuable guidance. In client management, you will provide an additional support tier to the supervisor addressing policy and claims issues, building and maintaining strong relationships, attending key meetings, ensuring compliance with client instructions, and documenting interactions while always acting in the client's best interest. Join us and make a difference every day!

Primary Responsibilities

Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:

Claims Technical Leadership

• Consistently strive to improve and streamline current processes
• Authorize release of payment and settlement
• Make daily claims decisions regarding plan of action, handling of payment, etc.
• Review claim files for accuracy
• Run various reports with an eye for accuracy and confidentiality
• Approve payments and reserve increases when they rise above Examiner’s authority level
• Work collaboratively with internal and clients’ senior management as well as with attorneys to draft settlements and assist with litigation strategies
• Provide timely information to clients, attorneys, doctors, investigators and injured workers with strong, professional communication
• Discuss appropriate medical treatment with medical case manager
• Assure consistent and accurate claims coding is occurring on the team
• Ensure quality file handling and resolution. This includes meeting unit closing goals, verifying proper reserves, providing thorough claims analysis and guiding to correct resolution
• Use flexibility when working in demanding and changing situations
  
  
  

Management Support

• Effectively plan, organize and delegate workload for Future Medical Examiners for optimal results and ensure time commitments are met. Encourage professional development and reviewing performance through evaluations, feedback, goal setting, and identifying areas for improvement
• Support and supervise the daily activities of the team by monitoring progress, ensuring compliance with policies and claim handling standards
• Identify, coordinate, coach, and perform training with staff to improve performance and increase their growth and knowledge in claims
• Participate in the interview process, onboarding and training of new hires
• Provide general guidance to the team by offering technical support and advice on work-related issues, fostering a positive work environment, encouraging professional development
• Provide direct feedback and use sound coaching techniques to solve disciplinary or workflow problems. Manage and document employee relations issues at all levels. Work in conjunction with Human Resources to ensure performance issues are managed in a timely and consistent manner
• Identify and escalate disciplinary or workflow concerns by providing detailed feedback and insights to the team supervisor. Support documentation efforts and assist the supervisor in ensuring performance matters are addressed in a timely and consistent manner
• Regularly lead organized and collaborative staff unit meetings, including both remote and on-site employees
• Maintain an open-door policy and an approachable attitude, and foster open communication with staff
• Support the Supervisor by completing Supervisor Review notepads on the overall claim inventory for the program.
• Assist the supervisor in the planning and scheduling of claim reviews with the client, as well as be prepared to lead those claim reviews if needed in the event the supervisor is unable to attend
  
  
  

Client Management Support

• Work with clients with issues regarding policies, programs and/or claims
• Attend client meetings, internal meetings, and workers’ compensation meetings both virtual and in-person
• Ensure notepads and diaries are set and completed timely in accordance with client handling instructions and Athens Best Practices and have meaningful action plans and information and are concise and well-written
• Obtain audit results meets or exceeds best practice standards of Athens and client
• Display integrity and always acts in the best interest of the client
• Document client meeting notes in appropriate shared location
  
  
  

Supervisor Responsibilities

Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions.

• Provide direct supervision to two Future Medical Examiners
• Attend on-site Leadership Summit at Athens Concord headquarters every 18 months (including overnight)
  
  
  

Fiscal Responsibilities

• Review and approve direct report’s monthly expense reports
• Ensure that all expenditures are in the best interest of the Company
• Use effective monitoring and reporting mechanisms to control expenses without lowering quality
• Obtain, maintain, and demonstrate an understanding of wage and hour laws as applicable for employees
• Ensure timely, accurate review and approval of timecards for your staff on payroll processing days.
  
  
  

Essential Position Requirements

The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.

• High School Diploma or equivalent (GED) required for all positions
• AA/AS or BA/BS preferred but not required
• The Texas 03 Workers’ Compensation license is required
• The 08 All Lines License is preferred
• Solid and in-depth knowledge of Texas workers’ compensation laws, policies and procedures required
• Completion of IEA or equivalent courses
• Solid and in-depth knowledge of Texas workers’ compensation laws, policies, and procedures
• 3+ years’ recent workers compensation claims handling experience as a Lead examiner involving direct support to the team supervisor
• Proficiency in determining case value and negotiating settlements
• Prior Third-Party Administrator (TPA) experience preferred
• Understanding of medical and legal terminology
• Strong attention to detail and organizational skills and the ability to research and resolve problems and meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives.
• Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency.
• Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing them to execute tasks
• Handles stressful situations and deadline pressures well
• Must demonstrate accuracy and thoroughness in work product
• Effectively influences people to achieve unit and organizational objectives
• Must be flexible, adaptable, and positive. Exhibit passion and energy to ensure that all employees are respected and treated in a manner consistent with Athens Values.
• Able to plan, prioritize and organize claims workload for a unit
• Skilled at presenting in small and large group settings
• Ability to create reports as required, using the report writing tools available or creating custom documents.
• Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals
• Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully.
• Able to interpret information from multiple sources and draw logical conclusions; consults others based on analysis of data; able to think strategically and use data findings to consult others for improved business results.
• Negotiating skills
• Mathematical calculating skills
• Exercise independent judgment and analytic ability in solving complex and sensitive problems
• Highly developed verbal and written communication skills with strong attention to detail
• Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency
• Proficient in Microsoft Office Suite
• Ability to type quickly, accurately and for prolonged periods
• Ability to learn additional computer programs
• ClaimsXpress program experience preferred but not required
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
• Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
• Valid Driver’s license and availability for travel including in office file reviews and meetings
  
  

APPLY WITH US

We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.

Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

THANK YOU!

We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!

Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here