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Claims Operations Team Lead
2 months ago
Company Overview:
Sedgwick is a premier global provider of technology-driven risk, benefits, and integrated business solutions. Our commitment to excellence is reflected in our culture of care, where we prioritize the well-being of our colleagues and clients alike.
Position Summary:
The Claims Team Lead will oversee the operations of various teams of examiners and technical personnel specializing in workers' compensation. This role involves monitoring workloads, providing training, and guiding individual claim activities. The Team Lead will also offer technical and jurisdictional direction on claims adjudication and maintain a comprehensive diary on claims managed by the teams, particularly focusing on complex or high-exposure cases.
Key Responsibilities:
- Supervise multiple teams of examiners and technical operations staff, ensuring effective delegation of tasks.
- Identify trends and issues, advising management on recommended actions and process improvements.
- Provide technical guidance on claims adjudication to examiners.
- Conduct quality reviews of claims to ensure compliance with audit and service contract standards.
- Act as a second level of appeal for client and claimant inquiries regarding claims.
- Review reserve amounts for high-cost claims and those exceeding examiner authority.
- Maintain communication with clients, fostering professional relationships and providing updates on claim statuses.
- Ensure all direct reports are properly licensed and that claims files are accurately documented.
Supervisory Duties:
Administer company policies and standards while providing leadership and motivation to enhance team performance.
Qualifications:
- Bachelor's degree from an accredited institution is preferred.
- Minimum of six years of claims experience, including two years in a supervisory role.
- Strong knowledge of claims management processes across multiple product lines.
- Excellent communication skills, both oral and written.
- Proficient in Microsoft Office and other relevant software.
- Demonstrated leadership and organizational skills.
Compensation and Benefits:
Sedgwick offers a comprehensive benefits package, including medical, dental, vision, 401k with matching, paid time off, and more. We are committed to providing a fair and inclusive workplace where every individual can thrive.
At Sedgwick, we believe that taking care of people is at the core of our mission. Join us in making a positive impact through our services.
