Claims Team Lead | GL & BI | Jurisdiction: MN | Licensing: MN - Remote

SedgwickEden Prairie, MN
$73,231 - $102,523Remote

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. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead | GL & BI | Jurisdiction: MN | Licensing: MN - Remote Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Requirements

  • High School Diploma or GED required.
  • 6 years of claims management experience or equivalent combination of education and experience required.
  • two (2) years claims supervisor experience.
  • MN

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, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
  • Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
  • Provides technical/jurisdictional direction to examiner reports on claims adjudication.
  • Compiles reviews and analyzes management reports and takes appropriate action.
  • Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
  • Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
  • Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
  • Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
  • Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
  • Assures that direct reports are properly licensed in the jurisdictions serviced.
  • Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
  • Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
  • Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
  • Provides support, guidance, leadership and motivation to promote maximum performance.

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Opportunity to work in an agile environment.
  • Career development and promotional growth opportunities.
  • medical, dental vision, 401K on day one.
  • 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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