Job Description
**Preference given to those who meet the qualifications and are located in Central or Eastern time zone.
States to be covered: OH, IN, MI, KY, VA, WV, MD
Applications for this posting will be accepted until 7/8/2026.
ADP is hiring a Lead Claims Examiner. In this position you will perform the following basic functions:
- Supervisory responsibility for Claims Examiner I and Senior Examiner.
- To aid in overall claim cost reduction by coordinating efforts between all involved vendors, clients and WES.
- Additional level to monitor applicable claims assigned to Claims Examiner I and Senior Examiner.
- To ensure TPA/Carrier accountability in agreed performance standards and coordinate needs for changes with Claims Director.
- To accumulate data for the purpose of creating standards for measurement of various claim related issues, as well as customer service and internal staff performance.
RESPONSIBILITIES:
- Reviews and recommends acceptability of all Workers' Compensation Claims within claim distribution.
- Accountability for the Claim Unit's efforts in all RTW efforts, OSHA documentation and all documentation of claim activity according to stated claim procedures.
- Works directly with Claims Director to determine workloads and the necessity of procedure changes within the Claims Unit.
- Assists in online audits of TPA to insure quality compliance of claim procedures and client satisfaction in Workers' Compensation claims handling.
- Maintaining e-time and PTO/Sick time coordination for the Claims Unit., has one administrative direct report and mentor/coaching responsibilities for the Claims Examiner.
- Responsible for communication with internal/external clients, claimants, related vendors as well as TPA/Carrier activity for TotalSource work-site employee claims to include personal visits to each region.
- Requires basic knowledge of Workers' Compensation laws for all jurisdictions.
- Attends professional development courses and seminars to keep TotalSource current with related workers' compensation laws and standards.
- Represents client in legal activities related to Workers' Compensation Claims within authority.
- To review, audit and support the examiner positions.
- To generate routine reports for productivity level evaluation.
- To support the Claims Director in daily/monthly/quarterly tasks and projects that aid in the claim operation reach it's specified goals.
TO SUCCEED IN THIS ROLE: Required Qualifications
- 5 years WC Indemnity adjusting or industry related experience.
- Maintain knowledge of basis Workers Compensation Laws in applicable jurisdictions- OH, MI, IN, KY, WV, VA, ME
- Direct or indirect leadership/supervisory experience.
A college degree is great but not required. What's more important is having the skills to do the job. If you don't have a college degree, other acceptable experiences could include:
- Experience noted above, OR
- Military experience where skills including teamwork, adaptability, organization, and follow-through will help you build team and client relationships, identify solutions, and achieve success.
Qualifications
BONUS POINTS FOR THESE Preferred Qualifications
- PEO experience desirable.
- College Degree a plus.
- Stay abreast of strategies and current industry related ideologies in dealing with Workers' Compensation Claims.
- Maintain adequate resources to enable continued education in Workers' Compensation and RTW issues.
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