Workers' Compensation Lead Claims Examiner

 

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.