Claims Team Lead - Workers Compensation - Sea Tac, WA - Hybrid jobs in United States
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Sedgwick · 5 months ago

Claims Team Lead - Workers Compensation - Sea Tac, WA - Hybrid

Sedgwick is a global industry leader known for its excellence and customer service. The Claims Team Lead will supervise multiple teams of examiners and technical staff for workers compensation, ensuring compliance with quality standards and providing technical direction on claims adjudication.

BankingInsuranceRisk Management

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
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

Qualification

Claims experienceClaims supervisor experienceProfessional certificationsBachelor's degreeTechnical directionEmpathyAccountabilityInclusionLeadershipCollaborationGrowth

Required

Bachelor's degree from an accredited college or university preferred
Licenses as required
Professional certifications as applicable to line of business preferred
Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience

Benefits

Medical
Dental
Vision
401k and matching
PTO
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits

Company

Sedgwick

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Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.

Funding

Current Stage
Late Stage
Total Funding
$1.5B
Key Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired

Leadership Team

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Michael Arbour
Chairman & Chief Executive Officer
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Kalani Reelitz
Global Chief Financial Officer
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Company data provided by crunchbase