Division Claims Manager - Workers' Comp California

Full Description here: https://www.athensadmin.com/careers/job-openings/

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 a full-time Division Claims Manager to support our Workers Compensation department by leading a team of supervisors in our Southern California market. Management that lives less than 36 miles from the Orange, CA offices 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 Southern California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday.

The Division Claims Manager is a key leader within Athens Administrators’ Workers’ Compensation division, responsible for overseeing the performance, development, and results of a team of Claims Supervisors and ancillary claims staff. This role serves as a strategic partner to senior leadership, clients, and internal stakeholders, ensuring high‑quality claims handling, operational excellence, and alignment with client expectations.

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:

Strategic & Operational Leadership

• Serve as a member of the Senior Operations Group (SOG), collaborating with executives on company initiatives, process improvements, and performance goals.
• Oversee claims operations to ensure regulatory compliance, consistent application of best practices, and high-quality claim outcomes.
• Lead process optimization efforts, leveraging data and cross-departmental partnerships to enhance efficiency and client results.
• Ensure accurate and consistent claims coding, reserve practices, diary maintenance, and overall file quality across the division.
• Review audit results and incorporate findings into department quality initiatives.

Team Leadership, Coaching & Development

• Provide daily guidance, coaching, and direct supervision to Claims Supervisors and partial supervision to Hearing Representatives, Investigators, and other ancillary staff.
• Lead staff meetings, communicate company priorities, and foster an open-door environment that encourages transparency and collaboration.
• Oversee hiring processes in partnership with Human Resources, including candidate selection, interview evaluation, and feedback.
• Set clear performance expectations and developmental goals and conduct formal performance evaluations.
• Address employee relations issues promptly and consistently, working with HR as needed.
• Support a culture that reflects Athens' values of integrity, collaboration, and service excellence.

Client Relationship Management

• Manage key client relationships by being accessible, proactive, and solutions‑oriented.
• Respond promptly to client inquiries and identify potential issues before they escalate.
• Attend client meetings and present annual stewardship reports.
• Document client interactions and meeting notes in appropriate shared systems.
• Collaborate with the Sales Team on presentations for prospective clients.

Claims Oversight & Technical Expertise

• Provide daily direction on claim strategy, settlements, reserves, litigation planning, compensability decisions, and overall file handling.
• Authorize settlement agreements and significant payments within assigned authority limits.
• Work collaboratively with attorneys, investigators, and medical professionals to resolve complex or sensitive claims.
• Ensure unit closing goals, reserve accuracy standards, and quality metrics are consistently achieved or exceeded.

Training & Knowledge Development

• Coordinate and deliver claims training for new and existing staff.
• Promote continuous learning, professional development, and mastery of changing laws, practices, and internal procedures.

ACCOUNTABILITIES

Supervisory Responsibilities

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

• Provide direct supervision to Claims Supervisors. Also provide partial direct supervision to ancillary staff, such as Hearing Representatives, investigators, etc.
• Responsible for performance management of direct reports

Fiscal Responsibilities

• Participate in budget development, forecasting, and cost-control initiatives.
• Review and approve staff expense reports and educational reimbursement requests.
• Ensure expenditures and resource allocation align with company objectives and financial responsibility.
• Understand and enforce wage and hour laws applicable to supervised staff.
• Accurately review and approve timecards when required.

Managers in the Field Responsibilities:

For designated branch locations, oversee facility operations including security, maintenance, safety, and parking coordination.

ESSENTIAL POSITION REQUIREMENTS - FULL DETAILS HERE https://www.athensadmin.com/careers/job-openings/

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.

Education & Professional Certifications

• High School Diploma or GED required; AA/AS or BA/BS strongly preferred.
• Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
• Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
• Completion of IEA coursework or equivalent.

Experience Requirements

• Minimum 3 years of supervisory experience, including hiring, training, coaching, developing, directing, and retaining staff.
• Minimum 2 years of management experience in a Workers’ Compensation office.
• Prior Workers’ Compensation claims handling experience, including reserve management, case valuation, and settlement negotiation.
• Prior Third-Party Administrator (TPA) experience preferred.

Technical & Industry Knowledge

• Strong understanding of Workers’ Compensation laws, policies, procedures, and best practices.
• Proficiency in evaluating claim exposure, quality file handling, and guiding claims to appropriate resolution.
• Understanding of medical and legal terminology.
• Proficient in Microsoft Office Suite; able to learn additional systems and leverage technology to improve efficiency.
• Strong mathematical and analytical abilities.
• Ability to type accurately and for sustained periods.

Results & Operational Excellence

Leadership, Coaching & People Management

Client Relationship Management & Service Commitment

Financial, Resource & Operational Stewardship

Professionalism, Integrity & Confidentiality

Work Environment & Travel Requirements

• Ability to attend frequent in‑office meetings and file reviews.
• Willingness to attend off‑site client meetings and conferences.
• Valid driver’s license and availability for travel, including overnight.

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

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!