Claims Team Lead - Workers Compensation (Dedicated Client) | Concord, CA
About The Position
This role oversees a team of examiners and technical staff handling workers compensation claims for a dedicated client. The Claims Team Lead manages workloads, provides training, and monitors individual claim activities. They offer technical and jurisdictional guidance on claims adjudication and maintain regular diaries, especially for complex or high-exposure cases. The position is with Sedgwick, a global industry leader known for its excellence and customer service, offering opportunities for career growth, professional development, and a caring culture with work-life balance. The company has been recognized by Newsweek, Fortune, and Certified as a Great Place to Work®.
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 a team 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
- Medical insurance
- Dental insurance
- Vision insurance
- 401K on day one
- Matching 401K
- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Employee assistance program
- Flexible spending or health savings account
- Other additional voluntary benefits
- Disability insurance
- Life insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
