Claims Team Lead - Litigation
The Judge Group Inc.

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

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