Workers Compensation Claims Team Lead, NY Jurisdiction Experience

Job not on LinkedIn

🔥 22 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $95k - $105k / 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 operations colleagues • Monitor colleagues' workloads and individual claim activities • Provide training and technical/jurisdictional direction on examiner reports and claims adjudication • Maintain claim diaries, including frequent diaries for 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 • Coordinate projects with management • Compile, review, and analyze management reports and take appropriate action • Perform quality reviews on claims in compliance with audit, service contract, and quality standards • Act as second-level appeal authority for client and claimant issues and implement final dispositions • Review reserve amounts on high-cost claims and claims exceeding examiner authority • Monitor third-party claims and review litigated, serious vocational rehabilitation, questionable, and sensitive claims • Maintain client contact, recommend actions based on claim status, and provide written claim summaries • Ensure direct reports are properly licensed in serviced jurisdictions • Ensure claims files are correctly coded and adequately documented • Administer personnel policies, interview and hire colleagues, establish performance development plans, conduct performance discussions, and provide leadership and motivation

🎯 Requirements

• Bachelor's degree from an accredited college or university preferred • Licenses as required • Professional certifications as applicable to line of business preferred • Ten (10) years of claims experience or equivalent combination of education and experience required • Two (2) years of claims supervisor experience required • NY jurisdiction knowledge • NY licensing • Ability to supervise multiple teams of examiners and technical staff • Ability to provide technical/jurisdictional direction on claims adjudication • Ability to monitor workloads and claim activities • Ability to review reserves and complex, litigated, serious, questionable, and sensitive claims • Ability to ensure claims files are correctly coded and adequately documented • Ability to administer personnel policies, interview, hire, and conduct performance discussions

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision coverage • 401K and matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Work-life balance • Professional development opportunities • Flexibility and autonomy in daily work, location, and career path