Workforce Absence Team Lead

Sedgwick•Chicago, IL

About The Position

The Workforce Absence Team Lead supervises multiple teams of disability claims examiners and technical staff. The role monitors workloads and claim activities, provides training and technical or jurisdictional guidance on claims adjudication, and maintains claim diaries, including frequent reviews of complex or high-exposure claims. The Team Lead reviews reports, claim quality, reserves, appeals, and sensitive or litigated claims; works with clients on claim status and recommendations; and ensures proper licensing, file coding, and claim documentation. The role also oversees staffing and colleague performance and supports organizational quality programs.

Requirements

Six years of claims experience, or an equivalent combination of education and experience.
Thorough knowledge of disability claims management procedures and processes.
Excellent oral and written communication skills, including presentation skills.
Computer literacy, including Microsoft Office products.
Leadership, management, and motivational skills.
Analytical and interpretive skills.
Strong organizational and interpersonal skills.
Excellent negotiation skills.
Ability to work in a team environment and meet or exceed performance competencies.
Licenses as required.
Ability to handle work-related stress, multiple priorities, and deadlines.
Ability to perform computer keyboarding; travel as required.
Ability to meet the role's auditory and visual requirements, including hearing, vision, and talking.

Nice To Haves

Bachelor's degree from an accredited college or university.
Professional certifications applicable to the line of business.
Two years of claims supervisory experience.

Responsibilities

Supervise multiple teams of examiners and/or technical operations colleagues, delegating duties as appropriate.
Monitor colleagues' workloads and individual claim activities, and provide training.
Identify and report trends, problems, and issues to management; recommend courses of action and process improvements; and coordinate office projects.
Provide technical and jurisdictional direction on claims adjudication.
Compile, review, and analyze management reports and take appropriate action.
Conduct quality reviews of claims in accordance with audit requirements, service contract requirements, and quality standards.
Serve as the second level of appeal for client and claimant issues and implement final appeal dispositions.
Review reserves for high-cost claims and claims exceeding individual examiner authority.
Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and client-designated sensitive claims.
Maintain client contact, foster professional client relationships, make claim-status recommendations, and provide written claim summaries when requested.
Ensure direct reports hold required licenses in the jurisdictions served.
Ensure claim files are correctly coded and adequately documented by examiners.
Administer personnel policies and follow company staffing standards and training recommendations.
Interview and hire colleagues, establish performance development plans, conduct performance discussions, and provide leadership and support.
Perform other assigned duties and support organizational quality programs.