About The Position

This role oversees multiple teams of examiners and technical staff handling workers compensation claims for clients. The position involves managing workloads, providing training, and monitoring individual claim activities. The Claims Team Lead offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex or high-exposure cases. The ideal candidate embodies Sedgwick's caring counts model and core values, including empathy, accountability, collaboration, growth, and inclusion. This is a hybrid role, requiring 3 days in the office and 2 days remote.

Requirements

  • 6 years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
  • High School Diploma or GED required.
  • California workers compensation claim handling experience
  • SIP Certified

Nice To Haves

  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.

Responsibilities

  • Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
  • Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
  • Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
  • Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
  • Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
  • Maintains professional client relationships, offering recommendations and written summaries as needed.
  • Ensures accurate claim coding and documentation by examiners.

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • Medical insurance
  • Dental insurance
  • Vision insurance
  • 401K on day one
  • 401K matching
  • PTO
  • Disability insurance
  • Life insurance
  • Employee assistance program
  • Flexible spending account
  • Health savings account
  • Other additional voluntary benefits
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