Workers Compensation Claims Team Lead | New York Jurisdiction | Dedicated Client

Sedgwick•Syracuse, NY

12d

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 Workers Compensation Claims Team Lead | New York Jurisdiction | Dedicated Client We are seeking a highly motivated and experienced Workers' Compensation Claims professionals to join our team. The ideal candidate will have at least 5 years of claims handling experience, with a strong background in New York jurisdictional regulations and processes. Supervisory experience preferred. This position is responsible for supervising multiple teams of workers' compensation examiners , ensuring timely and accurate decisions while adhering to all applicable laws and regulations. We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Requirements

Experience: Minimum of (5) years of workers' compensation claims handling experience.
Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers' Compensation Board rules and procedures.
Experience with Public Entity claims management.
Education: High school diploma or equivalent; a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.
Skills and Abilities: Strong understanding of workers' compensation claims processes, policies, and legal requirements in New York.
Excellent written and verbal communication skills.
Strong analytical skills with attention to detail and accuracy.
Ability to manage multiple claims simultaneously and prioritize workload effectively.
Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
Ability to negotiate settlements and resolve claims disputes effectively.

Nice To Haves

Supervisory experience preferred.
a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.

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.

Benefits

Flexible work schedule.
Capped Case Load.
In-depth training.
Sedgwick funded licensing.
Referral incentive program.
Opportunity to work in an agile or remote environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
PTO
disability and life insurance
employee assistance
flexible spending or health savings account
other additional voluntary benefits.