[Hiring] Workers Compensation - Claims Team Lead @Sedgwick

Role Description

Oversees multiple teams of examiners and technical staff handling workers compensation claims for clients. Manages workloads, provides training, and monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex or high-exposure cases.

Essential Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
• Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
• Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
• Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
• Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
• Maintains professional client relationships, offering recommendations and written summaries as needed.
• Ensures accurate claim coding and documentation by examiners.

Qualifications

• 6 years of claims experience or equivalent combination of education and experience required, including two (2) years claims supervisor experience.
• High School Diploma or GED required; Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• SIP & California Workers Compensation claims handling experience.

Requirements

• Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion.
• Ability to handle work-related stress and multiple priorities simultaneously.
• Ability to meet deadlines.
• Computer keyboarding skills.
• Hearing, vision, and talking capabilities.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one.