Workers Compensation Claims Team Lead – NY Jurisdiction

🔥 1 minute 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 workloads and individual claim activities • Provide training and technical/jurisdictional direction on claims adjudication • Maintain claim diaries, including frequent diaries for complex or high-exposure claims • Identify trends, problems, and issues and recommend courses of action • 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 reserves 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 and promote professional client relationships • Make claim-status recommendations and provide written claim resumes as requested • Ensure direct reports are properly licensed in serviced jurisdictions • Ensure claims files are correctly coded and adequately documented • Administer personnel policies and follow staffing and training standards • Interview, hire, establish performance development plans, and conduct performance discussions • Provide support, guidance, leadership, and motivation to promote maximum performance

🎯 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 • NY jurisdiction knowledge • NY licensing • Ability to supervise multiple teams of examiners and technical staff • Ability to handle multiple priorities and meet deadlines • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Computer keyboarding • Hearing, vision, and talking

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401(k) and matching • Paid time off (PTO) • Disability and life insurance • Employee assistance program • 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