Claims Team Lead - Workers Compensation
New
S
SedgwickInsurance
United StatesFull-TimeLead
Salary not disclosed
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Job Details
- Experience
- Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
- Required Skills
- Quality AssuranceClient relationship managementRisk Management
Requirements
- High School Diploma or GED required; Bachelor's degree preferred.
- Six years of claims experience required.
- Two years of experience in a claims supervisor role required.
- Deep jurisdictional knowledge of California workers' compensation.
- Professional certification applicable to the line of business preferred.
- Ability to manage workloads for a team of at least seven staff.
- Strong judgment, analytical, and troubleshooting skills.
- Proficiency in claims documentation and coding practices.
- Ability to handle multiple priorities and meet deadlines in a fast-paced environment.
- Ability to travel as required.
Responsibilities
- Supervise multiple teams of examiners and technical operations staff.
- Provide technical and jurisdictional direction on claims adjudication.
- Perform quality reviews on claims to ensure compliance with audit and service requirements.
- Act as a second level of appeal for client and claimant issues.
- Review reserve amounts on high-cost claims and claims exceeding individual examiner authority.
- Maintain professional client relationships and provide updates on claim statuses.
- Identify trends and advise management on process improvements.
- Interview, hire, and manage the performance development of direct reports.
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