ESIS Claims Team Leader, WC

Are you interested in building your career in workers’ compensation and claims support? Join ESIS, a leader in risk management and insurance services, where you can contribute to effective claims handling and support employees during important moments.

Position Summary
The Workers’ Compensation Claims Supervisor is responsible for leading a team of claims professionals to support high-quality claim handling, strong technical file management, effective customer service, and compliance with ESIS and client requirements. This role provides day-to-day leadership, coaching, technical guidance, and performance management while supporting operational effectiveness, loss cost control, and continuous improvement.

General Responsibilities

• Improve the technical quality of claim files handled by the team.
• Serve as a team facilitator by helping remove barriers and resolve issues proactively.
• Contribute as a key member of the Claims Office Workers’ Compensation Management Team.
• Support team development, loss cost management, and customer service.
• Promote ESIS management principles, team-building practices, and organizational values.
• Use current claims systems and tools effectively.
• Analyze data to identify individual and team development opportunities.
• Assess knowledge and skill gaps and develop action plans for improvement.
• Support and reinforce ESIS claims strategies and values.
• Address human resources and employee relations matters appropriately.
• Demonstrate a proactive, service-oriented approach to internal and external customers.
• Apply strong technical knowledge of workers’ compensation claim handling.
• Provide one-on-one coaching, counseling, and performance feedback.
• Evaluate programs, procedures, and workflows to support continuous improvement.

Specific Responsibilities

• Review and assign new claims based on customer needs, complexity, and team workload.
• Establish initial reserves and provide early claim direction to adjusters, as appropriate.
• Identify and address issues involving compensability, medical management, subrogation, and related claim factors.
• Ensure claim coding and file documentation are accurate and compliant.
• Monitor claim diaries and follow up on system-generated and file-specific deadlines.
• Review files at key checkpoints for investigation quality, medical management, subrogation opportunities, statutory compliance, reserve accuracy, and fraud indicators.
• Provide direction consistent with ESIS best practices, account requirements, and carrier expectations.
• Participate in account discussions when claim issues require escalation beyond the adjuster level.
• Review status reports and participate in file reviews as needed.
• Manage team performance, including attendance, file quality, service standards, and interpersonal effectiveness.
• Ensure reserve adequacy in accordance with ESIS and carrier requirements.
• Participate in litigation strategy discussions and support claim resolution planning.
• Review, correct, and complete internal documents related to reserves, appeals, audits, and compliance requirements.
• Participate in the management of catastrophic injury claims with account partners, nurses, adjusters, claim leadership, home office, and carriers.
• Conduct quality audits and individual file reviews.
• Provide feedback and responses to carrier, customer, and broker reviews.
• Coordinate training for the team and office on jurisdictional, medical, procedural, carrier, and account-specific requirements.
• Resolve elevated customer, claimant, broker, and carrier concerns.
• Balance caseloads across the team and office to support workload equity and service standards.
• Train new hires in all aspects of claim handling.
• Monitor and support timely and accurate claim closure.