Claims Team Lead, Auto | Bodily Injury

Sedgwick•St. David's, SC

14d

About The Position

The Claims Team Lead supervises multiple teams of examiners and technical staff handling client liability claims. The role monitors workloads and claim activity, provides training and technical and jurisdictional direction on claims adjudication, and maintains claim diaries, including frequent reviews of complex or high-exposure claims. The position also supports quality programs and manages supervisory responsibilities, including hiring, performance development, and colleague guidance.

Requirements

Six years of claims experience, or an equivalent combination of education and experience, including two years of claims supervisor experience.
Thorough knowledge of claims management processes and procedures for multiple product lines.
Excellent oral and written communication skills, including presentation skills.
Computer literacy, including Microsoft Office products.
Leadership, management, and motivational skills.
Analytical and interpretive skills.
Strong organizational skills.
Excellent interpersonal skills.
Excellent negotiation skills.
Ability to work in a team environment.
Ability to meet or exceed Performance Competencies.
Licenses as required for the role.
Ability to perform computer keyboarding and meet the role’s hearing, vision, and talking requirements.
Clear and conceptual thinking, sound judgment and discretion, and ability to meet deadlines.

Nice To Haves

Bachelor’s degree from an accredited college or university.
Professional certifications applicable to the line of business.

Responsibilities

Supervise multiple teams of examiners and technical operations colleagues, delegating duties as appropriate.
Identify and advise management of trends, problems, and issues; recommend courses of action and suggest process improvements.
Coordinate office projects with management.
Provide technical and jurisdictional direction on examiner reports and claims adjudication.
Compile, review, and analyze management reports and take appropriate action.
Conduct quality reviews of claims to ensure compliance with audit requirements, service contract requirements, and quality standards.
Act as the second level of appeal for client and claimant issues involving claim-specific, procedural, or special requests, and implement final appeal dispositions.
Review reserves on high-cost claims and claims exceeding an individual examiner’s authority.
Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and client-designated sensitive claims.
Maintain client contact, foster professional client relationships, make recommendations based on claim status, and provide written claim summaries when requested.
Ensure direct reports hold required licenses in the jurisdictions served.
Ensure claims files are correctly coded and adequately documented by examiners.
Administer company personnel policies and follow staffing standards and training recommendations.
Interview and hire colleagues, establish performance development plans, and conduct performance discussions.
Provide support, guidance, leadership, and motivation to promote colleague performance.
Perform other assigned duties and support the organization’s quality programs.