Claims Team Lead - General Liability | Jurisdiction: All States | Licensing: Home State Required + NY Preferred (Remote)

Sedgwick•Gates, OR

20d•$80,000 - $100,000•Remote

About The Position

The Claims Team Lead - General Liability supervises multiple teams of claims examiners and technical staff serving clients. The role monitors workloads and claim activities, provides training and technical and jurisdictional direction, and maintains claim diaries, particularly for complex or high-exposure claims. The position also supports quality programs, client relationships, claim reviews, appeals, and staff development.

Requirements

High school diploma or GED.
Six years of claims experience, or an equivalent combination of education and experience, including two years of claims supervisor experience.
Home-state or reciprocal license required.
Jurisdiction knowledge covering all states.

Nice To Haves

Bachelor's degree from an accredited college or university.
Professional certification applicable to the line of business.
New York license.

Responsibilities

Supervise multiple teams of examiners, multiple product-line examiners, and/or at least seven technical operations colleagues; delegate duties as appropriate.
Identify trends, problems, and issues and advise management, recommend courses of action, share new procedures and process-improvement ideas, and coordinate office projects.
Provide technical and jurisdictional direction regarding examiner reports and claims adjudication.
Compile, review, and analyze management reports and take appropriate action.
Conduct quality reviews of claims in compliance with audit requirements, service contract requirements, and quality standards.
Serve 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, promote professional client relationships, recommend actions based on claim status, and provide written claim summaries when requested.
Ensure direct reports are properly licensed in the jurisdictions served.
Ensure claims files are correctly coded and adequately documented by claims 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 duties as assigned and support the organization's quality programs.