Ohio
Cleveland - Workers%27 Compensation Claims Supervisor- PN: 20069673
Ohio, Cleveland, Ohio, us, 44101
BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.
What You'll Be Doing
Under general direction, you will supervise one claims service team consisting of multiple claims specialists & multiple medical/rehab staff (e.g. Industrial Rehab Nurse, Rehab Case Management Specialist) in managing lost time compensation claims. Supervise and Lead Team-Oversee one claims service team consisting of multiple claims specialists, ensuring effective management of lost-time compensation claims. Develop and Implement Guidelines-Create and enforce new claims handling procedures to maintain compliance with state, federal, and BWC laws, rules, and regulations. Monitor Quality and Productivity-Review case assignments, monitor accuracy and timeliness, and utilize management reports to track pending cases and performance metrics. Identify and Resolve Issues-Address problem areas such as incorrect award calculations and insufficient documentation; recommend corrective actions. Ensure Documentation and Compliance-Verify that all necessary documentation is obtained for hearings and identify claims requiring vocational intervention based on injury severity and claimant history. Staff Development and Performance Management-Review and approve performance evaluations, recommend training or disciplinary actions, and participate in staff selection, training, and promotion processes. Effective Communication and Relationship Building- Ability to clearly convey expectations, provide constructive feedback, and build positive relationships with team members, injured workers, employers, and medical providers to foster collaboration and trust. To Qualify, You Must Clearly Demonstrate
Required Experience and/or Education
36 mos. exp. managing medical-only &/or lost-time claims, serving as primary decision maker to include making initial determination of claim, having overall responsibility & accountability of claim & management of claim to desired outcome. Or 36 mos. trg. or 36 mos. exp. in providing rehabilitation &/or medical management expertise in managing claims (e.g., develop return to work plans
AND
provide medical opinion; recommend, monitor &/or review medical treatment & determinations; provide job development training or career counseling enabling injured workers to return to work force). Or 24 mos. trg. or 24 mos. exp. in private insurance organization as claims representative, nurse or rehabilitation specialist
AND
12 mos. trg. or 12 mos. exp. providing work direction to claims processing staff. Or completion of undergraduate core program in business administration, public administration, human resources, finance, economics, nursing, social work, human service field (e.g., rehabilitation counseling) or related field
AND
12 mos. exp. in providing rehabilitation &/or medical expertise in managing workers' compensation claim (e.g., develop return to work plans; provide medical opinion; recommend, monitor & review medical treatment & determinations; provide job development training or career counseling enabling injured workers to return to work force), or 12 mos. exp. managing workers' compensation lost-time claims &/or medical-only claims serving as primary decision maker to include making initial determination of claim, having overall claim responsibility & accountability of claim & management of claim to desired outcome, or 12 mos. exp. supervising lower-level claims staff in managing medical only claims, or 12 mos. exp. in supervisory level position within Ohio Bureau Of Workers' Compensation which involved telephoned, in-person &/or written contact with providers, claimants, employers, public officials, attorneys &/or general public to provide information & answer inquiries concerning various operations, services &/or policies & procedures of agency. Or 36 mos. exp. in supervisory-level position within Ohio Bureau Of Workers' Compensation, 24 mos. of which involved telephoned, in-person &/or written contact with providers, claimants, employers, public officials, attorneys &/or general public to provide information & answer inquiries concerning various operations, services &/or policies & procedures of agency. Or equivalent of Minimum Class Qualifications For Employment noted above. Job Skills
Claims Examination Major Worker Characteristics
Knowledge of management, labor relations, employee training & development, supervision (direct), interviewing, public relations, service office practices & procedures*, agency policies & procedures*, state laws related to BWC claims & eligibility criteria & processing of workers comp claims*. Ability to deal with problems involving few variables within familiar context; define problems, collect data, establish facts & draw valid conclusions; calculate fractions, decimals & percentages; use proper research methods in gathering data & make impartial decisions; check data against records for accuracy; operate VDT & PC; read & understand medical reference manuals; prepare meaningful, concise & accurate reports; gather collate & classify information about data, people or things; proofread technical materials & make corrections; handle sensitive inquiries from & contacts with officials & general public; comprehend computer generated reports, oral & written business communications. (*) developed after employment.
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Under general direction, you will supervise one claims service team consisting of multiple claims specialists & multiple medical/rehab staff (e.g. Industrial Rehab Nurse, Rehab Case Management Specialist) in managing lost time compensation claims. Supervise and Lead Team-Oversee one claims service team consisting of multiple claims specialists, ensuring effective management of lost-time compensation claims. Develop and Implement Guidelines-Create and enforce new claims handling procedures to maintain compliance with state, federal, and BWC laws, rules, and regulations. Monitor Quality and Productivity-Review case assignments, monitor accuracy and timeliness, and utilize management reports to track pending cases and performance metrics. Identify and Resolve Issues-Address problem areas such as incorrect award calculations and insufficient documentation; recommend corrective actions. Ensure Documentation and Compliance-Verify that all necessary documentation is obtained for hearings and identify claims requiring vocational intervention based on injury severity and claimant history. Staff Development and Performance Management-Review and approve performance evaluations, recommend training or disciplinary actions, and participate in staff selection, training, and promotion processes. Effective Communication and Relationship Building- Ability to clearly convey expectations, provide constructive feedback, and build positive relationships with team members, injured workers, employers, and medical providers to foster collaboration and trust. To Qualify, You Must Clearly Demonstrate
Required Experience and/or Education
36 mos. exp. managing medical-only &/or lost-time claims, serving as primary decision maker to include making initial determination of claim, having overall responsibility & accountability of claim & management of claim to desired outcome. Or 36 mos. trg. or 36 mos. exp. in providing rehabilitation &/or medical management expertise in managing claims (e.g., develop return to work plans
AND
provide medical opinion; recommend, monitor &/or review medical treatment & determinations; provide job development training or career counseling enabling injured workers to return to work force). Or 24 mos. trg. or 24 mos. exp. in private insurance organization as claims representative, nurse or rehabilitation specialist
AND
12 mos. trg. or 12 mos. exp. providing work direction to claims processing staff. Or completion of undergraduate core program in business administration, public administration, human resources, finance, economics, nursing, social work, human service field (e.g., rehabilitation counseling) or related field
AND
12 mos. exp. in providing rehabilitation &/or medical expertise in managing workers' compensation claim (e.g., develop return to work plans; provide medical opinion; recommend, monitor & review medical treatment & determinations; provide job development training or career counseling enabling injured workers to return to work force), or 12 mos. exp. managing workers' compensation lost-time claims &/or medical-only claims serving as primary decision maker to include making initial determination of claim, having overall claim responsibility & accountability of claim & management of claim to desired outcome, or 12 mos. exp. supervising lower-level claims staff in managing medical only claims, or 12 mos. exp. in supervisory level position within Ohio Bureau Of Workers' Compensation which involved telephoned, in-person &/or written contact with providers, claimants, employers, public officials, attorneys &/or general public to provide information & answer inquiries concerning various operations, services &/or policies & procedures of agency. Or 36 mos. exp. in supervisory-level position within Ohio Bureau Of Workers' Compensation, 24 mos. of which involved telephoned, in-person &/or written contact with providers, claimants, employers, public officials, attorneys &/or general public to provide information & answer inquiries concerning various operations, services &/or policies & procedures of agency. Or equivalent of Minimum Class Qualifications For Employment noted above. Job Skills
Claims Examination Major Worker Characteristics
Knowledge of management, labor relations, employee training & development, supervision (direct), interviewing, public relations, service office practices & procedures*, agency policies & procedures*, state laws related to BWC claims & eligibility criteria & processing of workers comp claims*. Ability to deal with problems involving few variables within familiar context; define problems, collect data, establish facts & draw valid conclusions; calculate fractions, decimals & percentages; use proper research methods in gathering data & make impartial decisions; check data against records for accuracy; operate VDT & PC; read & understand medical reference manuals; prepare meaningful, concise & accurate reports; gather collate & classify information about data, people or things; proofread technical materials & make corrections; handle sensitive inquiries from & contacts with officials & general public; comprehend computer generated reports, oral & written business communications. (*) developed after employment.
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