Claims Team Lead – Workers Compensation

🔥 2 minutes ago

🏄 California, Florida – Remote

🏄 California – Remote 🐊 Florida – Remote

⏰ Full Time

🟠 Senior

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👻 Ghost score 10%

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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 diaries on claims, including complex or high exposure claims • Identify trends, problems, and issues and advise management on recommended actions • Coordinate management projects and continuous process improvement initiatives • Compile, review, and analyze management reports • Perform quality reviews on claims in compliance with audit, service contract, and quality standards • Act as second level of appeal for client and claimant issues and implement final dispositions • Review reserve amounts on high cost claims and claims over examiner authority • Monitor third party, litigated, serious vocational rehabilitation, questionable, and sensitive claims • Maintain client contact, promote professional client relationships, and make claim-status recommendations • Provide written claim summaries to clients as requested • Ensure claims files are correctly coded and adequately documented • Administer company personnel policies and staffing standards • Interview, hire, and establish colleague performance development plans • Conduct colleague performance discussions and provide leadership, guidance, and motivation • Support the organization's quality programs

🎯 Requirements

• 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 • Six (6) years of claims experience or equivalent combination of education and experience required • Two (2) years of claims supervisor experience required • CA licensing/jurisdiction knowledge • Direct reports must be properly licensed in the jurisdictions serviced • 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 • Ability to meet deadlines • Computer keyboarding • Travel as required

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision benefits • 401K on day one • Work-life balance • Professional development opportunities • Flexibility and autonomy in daily work, location, and career path • Diverse and comprehensive benefits supporting mental, physical, financial, and professional needs