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Sedgwick · 3 hours ago

Claims Team Lead - Workers Compensation (REMOTE)

United States

Full-time

Remote

Senior Level

$90K/yr - $100K/yr

6+ years exp

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

BankingInsuranceRisk Management

Responsibilities

Supervises multiple teams 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 supervisionJurisdiction experienceProfessional certificationClaims adjudicationEmpathyAccountabilityInclusionCollaborationGrowth

Required

Six (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

Licensed in WV and DE