Claims Team Lead - Workers Compensation (MUST RESIDE on OAHU, HI)
About The Position
By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. This role involves overseeing multiple teams of examiners and technical staff handling workers compensation claims for clients. The successful candidate will manage workloads, provide training, and monitor individual claim activities, offering technical and jurisdictional guidance on claims adjudication. The position requires adjudicating complex customer claims in the context of an energetic culture, delivering innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Sedgwick is a rapidly growing, industry-leading global company known for its excellence and customer service, offering professional development opportunities, flexibility, and comprehensive benefits. The company values empathy, accountability, collaboration, growth, and inclusion.
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.
- Hawaii License & workers comp claims handling experience.
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.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
- A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
High school or GED
Number of Employees
251-500 employees
