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Sedgwick · 2 days ago

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

Riverside, CA

Full-time

Hybrid

Mid, Senior Level

$105K/yr - $115K/yr

6+ years exp

Sedgwick is a global industry leader known for its excellence and customer service. The Claims Team Lead will oversee a team of examiners handling workers compensation claims, manage workloads, provide training, and offer technical guidance on claims adjudication.

BankingInsuranceRisk Management

Hiring Manager

Amy MacPherson

Responsibilities

Supervises a team of examiners, 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

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

Ensures accurate claim coding and documentation by examiners

Qualification

Claims supervisionCalifornia workers compensationTechnical guidanceClaims adjudicationEmpathyAccountabilityInclusionProcess improvementCollaborationGrowth