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Sedgwick · 1 month ago

Claims Team Lead - Workers Compensation | Hybrid - Riverside, CA

Riverside, CA

Full-time

Hybrid

Senior Level

$105K/yr - $115K/yr

6+ years exp

Sedgwick is a global industry leader in claims management, known for its caring culture and commitment to work-life balance. The Claims Team Lead will oversee teams handling workers compensation claims, manage workloads, provide training, and ensure proper claims adjudication while maintaining client relationships.

BankingInsuranceRisk Management

Responsibilities

Supervises a team of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards

Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims

Acts as a second-level appeal authority for client and claimant issues, implementing final decisions

Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects

Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases

Maintains professional client relationships, offering recommendations and written summaries as needed

Ensures accurate claim coding and documentation by examiners

Qualification

Claims supervisionCalifornia workers compensationProfessional certificationClaims adjudicationProcess improvementClient relationship managementTeam leadership

Required

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

High School Diploma or GED required

California workers compensation claims handling experience

SIP Certified

Preferred

Bachelor's degree from an accredited college or university

Professional certification as applicable to line of business

Benefits

Flexible work schedule.

Referral incentive program.

Career development and promotional growth opportunities.

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.