[Hiring] Claims Team Lead @Sedgwick

Role Description

To supervise the operation of personal injury protection examiner teams and technical staff for clients, monitor colleagues' workloads, provide training, and monitor individual claim activities, and to provide technical/jurisdictional direction to examiner reports on claims adjudication.

Essential Responsibilities

• Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews, and analyzes management reports and takes appropriate action.
• Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
• Assures that direct reports are properly licensed in the jurisdictions serviced.
• Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

Supervisory Responsibilities

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
• Provides support, guidance, leadership and motivation to promote maximum performance.

Qualifications

• Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
• Bachelor's degree from an accredited college or university preferred.
• Licenses as required.
• Professional certifications as applicable to line of business preferred.
• Thorough knowledge of claims management processes and procedures for multiple product lines.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office product.
• Leadership/management/motivational skills.
• Analytical and interpretive skills.
• Strong organizational skills.
• Excellent interpersonal skills.
• Excellent negotiation skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Benefits

• Opportunity to grow your career.
• Caring culture and work-life balance.
• Recognition as a Great Place to Work®.
• Inclusion in America’s Greatest Workplaces National Top Companies.
• Part of Fortune Best Workplaces in Financial Services & Insurance.