Claims Team Lead I – Workers Compensation

🔥 3 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $75k - $100k / year

⏰ Full Time

🟠 Senior

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Supervise multiple teams of workers compensation examiners and technical staff • Monitor colleagues' workloads and individual claim activities • Provide training and technical/jurisdictional direction on claims adjudication • Maintain claim diaries, including frequent diaries on complex or high-exposure claims • Identify trends, problems, and issues and advise management on recommended actions • Inform management of new procedures and continuous process improvement ideas • Compile, review, and analyze management reports and take appropriate action • Perform quality reviews on claims to meet audit, service contract, and quality standards • Act as second-level appeal for client and claimant issues and implement final appeal dispositions • Review reserve amounts on high-cost and over-authority claims • Monitor third-party, litigated, serious vocational rehabilitation, questionable, and sensitive claims • Maintain client contact, promote professional client relationships, and provide claim recommendations and written resumes • Ensure direct reports are properly licensed and claims files are correctly coded and documented • Administer personnel policies, interview and hire colleagues, establish performance plans, conduct performance discussions, and provide leadership and motivation

🎯 Requirements

• 5 years of California Workers Compensation claims management experience or equivalent combination of education and experience required • High School Diploma or GED required • Supervisory experience preferred • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • California jurisdiction knowledge • Must assure direct reports are properly licensed in the jurisdictions serviced

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Opportunity to work in an agile environment • Career development and promotional growth opportunities • Medical, dental, and vision benefits on day one • 401K and matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits