Claims Team Lead - Workers Comp @Sedgwick Claims Management Services Inc.

[Hiring] Claims Team Lead - Workers Comp @Sedgwick Claims Management Services Inc.

Mar 25, 2025 - Sedgwick Claims Management Services Inc. is hiring a remote Claims Team Lead - Workers Comp. 💸 Salary: unspecified. 📍Location: USA.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

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.
Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
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.

Qualifications

Bachelor's degree from an accredited college or university preferred.
Licenses as required.
Professional certifications as applicable to line of business preferred.
Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

Requirements

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 products.
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

Supports the organization's quality program(s).

Work Environment

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Physical: Computer keyboarding, travel as required.
Auditory/Visual: Hearing, vision and talking.

Similar Remote Jobs

Kickstart Your Job Search

Need advice to apply? Join our free Webinar « 3 Mistakes to Avoid When Looking For A Remote Startup Job (And What To Do Instead) »

Unlock 53,531 additional remote jobs, advanced search & email notifications

Get Access Now

Too many emails? Declutter your inbox with Meco

Your home for reading newsletters

Try for free - no card required.

Before You Apply

️

📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

Back to Remote jobs > All others

Claims Team Lead - Workers Comp @Sedgwick Claims Management Services Inc.

All others

Salary 💸 unspecified	Remote Location USA
Job Type unspecified	Posted Mar 25, 2025

Apply for this position Unlock 53,531 Remote Jobs

️

📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

Claims Team Lead - Workers Comp Apply for this position Unlock 53,531 Remote Jobs

Get daily remote job opportunities in your inbox

[Hiring] Claims Team Lead - Workers Comp @Sedgwick Claims Management Services Inc.

Similar Remote Jobs

More jobs at Sedgwick Claims Management Services Inc.

More All Others jobs

More jobs in USA

Kickstart Your Job Search