Absence Management Team Lead - Coding Team

Sedgwick; Dubuque (IA); On-site; USD 85,000 - 110,000; Full time

Job summary

Sedgwick seeks an Absence Management Team Lead to supervise multiple teams of examiners and technical staff for disability claims. You will monitor workload, provide training, and guide examiner reports while maintaining diaries on complex claims. The role requires leadership and strong communication across teams.

Candidates should have a Bachelor's degree, 6 years of claims experience, and 2 years in supervision. A hybrid work arrangement and proximity to Dubuque, IA are preferred.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Licenses as required; professional certifications as applicable to line of business preferred.
• Six years of claims experience; two years of supervisory experience preferred.

Responsibilities

• Supervises multiple teams of examiners and technical staff with a wide span of control.
• Identifies trends and advises management on issues and process improvements.
• Provides technical direction to examiner reports on claims adjudication.
• Reviews reports, analyzes data, and takes appropriate action.
• Performs quality reviews in compliance with audits and standards.
• Acts as second level of appeal for client and claimant issues.

Skills

Claims management procedures

Oral and written communication

PC literate

Leadership/management

Analytical skills

Organizational skills

Interpersonal skills

Negotiation skills

Teamwork

Deadline adherence

Education

Bachelor's degree

Licenses as required

Professional certifications

Job description

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & Insurance

Absence Management Team Lead - Coding Team

Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002

PRIMARY PURPOSE

To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Supervises multiple teams of examiners and/or several 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization’s quality program(s).

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.

QUALIFICATIONS

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

ExperienceSix (6) years of claims experience or equivalent combination of education and experience required. Two (2) years of claims supervisory experience preferred.

SKILLS & KNOWLEDGE

Thorough knowledge of claims management procedures and processes for disabilityExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsLeadership/management/motivational skillsAnalytical and interpretive skillsStrong organizational skillsExcellent interpersonal skillsExcellent negotiation skillsAbility to work in a team environmentAbility to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

Equal Opportunity Statement

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Company Culture

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.