Join Our Team as a Claims Team Lead Workers Compensation REMOTE
Are you a motivated and experienced claims professional looking for a new challenge? Do you want to take your career to the next level in a dynamic and supportive work environment? We're seeking a highly skilled Claims Team Lead Workers Compensation to join our team remotely! As a Claims Team Lead Workers Compensation REMOTE, you will play a critical role in supervising multiple teams of examiners and technical staff, providing technical direction, and ensuring exceptional client service.
About Sedgwick
Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. With over 30,000 colleagues across 80 countries, we help organizations protect their brand, minimize business interruptions, and guide consumers through the claims process. Our culture is built on caring, and we're committed to making a positive impact on the world through the people and organizations we serve.
Job Summary
We're looking for an experienced Claims Team Lead Workers Compensation to supervise multiple teams of examiners and technical staff for workers compensation claims. As a Claims Team Lead Workers Compensation REMOTE, you will be responsible for monitoring colleagues' workloads, providing training, and ensuring compliance with audit requirements and quality standards. You'll also provide technical/jurisdictional direction to examiner reports on claims adjudication and maintain a diary on claims in the teams.
Key Responsibilities
- Supervise multiple teams of examiners, multiple product line examiners, and/or several technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
- Identify and advise management of trends, problems, and issues, as well as recommended courses of action; inform management of new procedures and ideas for continuous process improvement.
- Provide technical/jurisdictional direction to examiner reports on claims adjudication.
- Compile, review, and analyze management reports and take appropriate action.
- Perform quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards.
- Act as the second level of appeal for client and claimant issues regarding claim-specific, procedural, or special requests; implement final disposition of the appeal.
- Review reserve amounts on high-cost claims and claims over the authority of the individual examiner.
- Monitor third-party claims; maintain periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as determined by the client.
- Maintain contact with the client on claims and promote a professional client relationship; make recommendations to the client as suggested by the claim status; and provide written resumes of specific claims as requested by the client.
- Assure that direct reports are properly licensed in the jurisdictions serviced.
- Ensure claims files are coded correctly and adequate documentation is made by claims examiners.
Requirements
Essential Qualifications
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certifications as applicable to the line of business preferred.
- Six (6) years of claims experience or equivalent combination of education and experience required, including two (2) years of claims supervisor experience.
- CA Workers Compensation experience is required.
Preferred Qualifications
- Experience in a supervisory role, preferably in workers compensation claims.
- Strong knowledge of workers compensation laws and regulations.
- Excellent communication and interpersonal skills.
- Ability to work in a fast-paced environment and prioritize multiple tasks.
What We Offer
Career Growth Opportunities
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering, including medical, dental, vision, 401K on day one.
Compensation
For the jurisdiction noted in this job posting only, the range of starting pay for this role is $90,000 - $110,000 per year. A comprehensive benefits package is offered, including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Why Join Sedgwick?
At Sedgwick, we believe in taking care of our colleagues and our clients. We're committed to creating a diverse, equitable, and inclusive workplace where everyone can thrive. Our culture is built on caring, and we're dedicated to making a positive impact on the world.
How to Apply
If you're excited about this role and think you'd be a great fit, apply now! We encourage you to apply even if your experience doesn't align perfectly with every qualification in the job description. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
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