Sedgwick
10,000+ employees
🏢 Enterprise
📋 Compliance
Insurance • Enterprise • Compliance
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.
Claims Team Lead – Workers Compensation
🕒 June 18
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Sedgwick
10,000+ employees
🏢 Enterprise
📋 Compliance
Insurance • Enterprise • Compliance
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 the operation of multiple teams of examiners and technical staff for workers compensation for clients • Monitor colleagues' workloads, provide training, and monitor individual claim activities • Provide technical/jurisdictional direction to examiner reports on claims adjudication • Maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims • Identify and advise management of trends, problems, and issues as well as recommended course of action • Inform management of new procedures and ideas for continuous process improvement • Provide quality review on claims in compliance with audit requirements, service contract requirements, and quality standards • Act as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests • 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 client • Maintain contact with the client on claims and promote a professional client relationship • Provide written resumes of specific claims as requested by 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
• 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
🏖️ Benefits
• medical • dental • vision • 401k and matching • PTO • disability and life insurance • employee assistance • flexible spending or health savings account • other additional voluntary benefits
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