Workers Compensation Claims Team Lead | Hybrid or Remote | Brea, CA

About the Role

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.

This position may be open to hybrid or remote settings for candidates located 25+ miles from a Sedgwick office in Brea, CA.

Responsibilities

• Supervises a team of workers compensation claims examiners and technical staff; 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.

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.

Requirements

• Six (6) years of California workers compensation claims management experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
• California jurisdictional knowledge required; SIP certification required or must be obtained within one (1) year of hire date.

Qualifications

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

Skills

• Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion.
• Ability to handle work-related stress and multiple priorities simultaneously.
• Ability to meet deadlines.
• Computer keyboarding.
• Strong auditory, visual, and verbal communication skills.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one.

Pay

The range of starting pay for this role is $100,000 - $115,000 for the jurisdiction noted in this job posting.