Claims Team Lead

2 weeks ago

Oklahoma City, Oklahoma, United States Sedgwick Full time

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work

Most Loved Workplace

Forbes Best-in-State Employer

Claims Team Lead - Workers Compensation REMOTE

PRIMARY PURPOSE: To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS and 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).

SUPERVISORY RESPONSIBILITIES

  • 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.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

Experience

Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

Skills & Knowledge

  • Thorough knowledge of claims management processes and procedures for multiple product lines
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Leadership/management/motivational skills
  • Analytical and interpretive skills
  • Strong organizational skills
  • Excellent interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. )


  • Senior Manager, Claims

    6 days ago

    Oklahoma City, Oklahoma, United States Trustmark Full time

    Trustmark's mission is to improve wellbeing – for everyone. It is a mission grounded in a belief in equality and born from our caring culture. It is a culture we can only realize by building trust. Trust established by ensuring associates feel respected, valued and heard. At Trustmark, you'll work collaboratively to transform lives and help people,...

  • Healthcare Claims Specialist

    3 weeks ago

    Oklahoma City, Oklahoma, United States Res-Care, Inc. Full time

    Our Company Amerita Overview Come join our closed-door specialty infusion pharmacy Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients...

  • Member Team Lead

    1 month ago

    Oklahoma City, Oklahoma, United States Walmart Full time

    Position Summary...What you'll do...Assists management with the supervision of associates in assigned area of responsibility by assigning duties to associates; communicating goals and feedback; training associates on processes and procedures; providing direction and guidance to associates on member service approaches and techniques to ensure member...

  • Member Team Lead

    1 month ago

    Oklahoma City, Oklahoma, United States Walmart Full time

    Position Summary...What you'll do...Assists management with the supervision of associates in assigned area of responsibility by assigning duties to associates; communicating goals and feedback; training associates on processes and procedures; providing direction and guidance to associates on member service approaches and techniques to ensure member...

  • Merchandising Lead

    1 month ago

    Oklahoma City, Oklahoma, United States Walmart Full time

    Position Summary...What you'll do...Provides member service by acknowledging the member and identifying member needs; providing guidance and support to members regarding self- service technology; assisting members with purchasing decisions; locating merchandise; resolving member issues and concerns; and promoting the company's products and services.Assists...

  • Certification Lead

    7 days ago

    Oklahoma City, Oklahoma, United States NTT DATA Services Full time

    Req ID: NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Certification Lead - Medicaid EVV to join our team in Oklahoma City, Oklahoma (US-OK), United States (US).The...

  • Warehouse Lead

    7 days ago

    Oklahoma City, Oklahoma, United States Aerotek Full time

    Description:Warehouse leads will manage a small team (5-7) people, make sure the correct orders are going out to the customer, perform documentation of shipping/receiving products, will work hands on with the team to perform warehouse tasks (load/unload/unbox/lift products)Skills:Inventory, Forklift, Rf scanner, Picking, Order puller, Inventory control,...

  • Injection Lead

    5 hours ago

    Oklahoma City, Oklahoma, United States Niagara Bottling LLC Full time

    At Niagara, we're looking for Team Members who want to be part of achieving our mission to provide our customers the highest quality most affordable bottled water.Consider applying here, if you want to: Work in an entrepreneurial and dynamic environment with a chance to make an impact. Develop lasting relationships with great people. Have the opportunity...

  • Merchandising Lead and Trainer

    6 days ago

    Oklahoma City, Oklahoma, United States Acosta, Inc. Full time

    Merchandising Lead and Trainer General Information Company: PRE-US Location: OKLAHOMA CITY, Oklahoma, 73118 Ref #: 35800 Function: Merchandising Employment Duration: Part-time Description and Requirements As a Merchandising Zone Lead and Trainer at Premium, your role is pivotal in ensuring the success of our field team. You'll achieve this by connecting...

  • Data Specialist Lead

    6 days ago

    Oklahoma City, Oklahoma, United States Love's Travel Stops Full time

    Req ID: 439417BASIC PURPOSE: The primary responsibility of the Data Specialist Lead is to effectively manage the data flow and maintenance of all products in SAP Pricebook. This role involves developing direct reports, ensuring the integrity of all product data to support Love's Retail and Supply Chain systems, and optimizing department processes....

  • Sales Lead

    3 days ago

    Oklahoma City, Oklahoma, United States Chico's FAS Full time

    Join our fashion-obsessed team, dedicated to a styling and social experience that makes women feel beautiful.POSITION OBJECTIVE:The Sales Lead is responsible for supporting Management in in promoting a customer and product-focused sales culture, where our values and guiding principles are at the forefront of all store operations, including great customer...

  • Sales Lead

    3 days ago

    Oklahoma City, Oklahoma, United States Chico's FAS, Inc. - Retail Full time

    Join our fashion-obsessed team, dedicated to a styling and social experience that makes women feel beautifulPOSITION OBJECTIVE:The Sales Lead is responsible for supporting Management in in promoting a customer and product-focused sales culture, where our values and guiding principles are at the forefront of all store operations, including great customer...

  • Sales Lead

    4 days ago

    Oklahoma City, Oklahoma, United States Chico's FAS, Inc. - Retail Full time

    We are customer obsessed, innovative, and have the best culture in retail.Join our team todayPOSITION OBJECTIVE:The Sales Lead is responsible for supporting Management in in promoting a customer and product-focused sales culture, where our values and guiding principles are at the forefront of all store operations, including great customer experience and...

  • XDT Market Supervisor

    7 days ago

    Oklahoma City, Oklahoma, United States Lowe's Full time

    What You Will DoThe XDT Market Supervisors are responsible for leading and supervising a team of approximately 3-7 local market Customer Service Associates. This role manager and analyzes the overall productivity of the office and ensures processes adherence.XDT Market Supervisors are responsible for the following activities:o Performance Management...

  • Bakery Lead

    2 weeks ago

    Oklahoma City, Oklahoma, United States Walmart Full time

    Position Summary...As a Bakery Department Lead you will drive sales in your area and supervise your team of hourly associates to deliver to our members more of what they love, for less. You will model expertise in Bakery and work collaboratively with other team leaders to ensure the total club meets the member's expectations.What you'll do...Be a Team...

  • Program Marketing Lead

    6 days ago

    Oklahoma City, Oklahoma, United States Paycom Online Full time

    Named one of America's fastest growing companies, Paycom helps businesses nationwide gain control over time-consuming HR and payroll processes, and engage employees. Using Paycom's cloud-based technology, companies quickly and easily hire top talent, run payroll, manage their workforce, train employees and comply with complicated regulations.The Program...

  • Training Lead- Medicaid-EVV

    6 days ago

    Oklahoma City, Oklahoma, United States NTT DATA Services Full time

    Req ID: NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Training Lead- Medicaid-EVV / State Agencies to join our team in Oklahoma City, Oklahoma (US-OK), United States...

  • Engineer Lead/Spec

    29 minutes ago

    Oklahoma City, Oklahoma, United States OG&E Full time

    Job Description: JOB INFORMATIONJob Code: or 125856JOB SUMMARYEqual Opportunity Employer - Minorities, Women, Individuals, with DisABILITIES & Veterans are Encouraged to Apply.We are hiring for either a Lead Electrical Engineer (or) a Senior Electrical Engineer based on candidates' qualifications.Primary responsibility is to support the execution of new...

  • PROSHOP - Retail Store Lead

    6 days ago

    Oklahoma City, Oklahoma, United States teamworkonline Full time

    Come join America's Team and be a part of the 5x Super Bowl Champion Dallas Cowboys Family Our winning tradition doesn't just happen on the field, it extends into our communities and retail stores. The Dallas Cowboys Pro Shops provide the ultimate game day experience while carrying the largest selection of official Cowboys fan gear. As part of the Team,...

  • Project Manager Lead

    1 month ago

    Oklahoma City, Oklahoma, United States OG&E Full time

    Requisition ID: 995JOB INFORMATIONJob Title: Project Manager LeadJob Code: 125728Grade: Exempt 59JOB SUMMARYManage new combustion turbine project. Additional new generation project/s or programs (as assigned) at the highest level of complexity and/or provide direct supervision within a matrix team environment. Provide leadership, direction, training,...