Absence Management Team Lead - Coding Team

Sedgwick Claims Management Services Ltd; Dubuque (IA); On-site; USD 70,000 - 100,000; Full time

Job summary

Sedgwick Claims Management Services seeks an Absence Management Team Lead to supervise multiple examiner teams and oversee disability claim activities. You will monitor workload, provide training, and guide technical direction for examiner reports and diaries.

The role requires six years of claims experience, at least two years in supervision, and strong communication skills to liaise with clients and internal teams.

Qualifications

• Bachelor's degree preferred; required licenses/certifications as applicable to the line of business.
• Six years of claims experience or equivalent combination of education and experience required.
• Two years of claims supervisory experience preferred.
• Thorough knowledge of claims management procedures for disability.
• Excellent oral and written communication, including presentation skills.

Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues.
• Identifies trends and issues; initiates process-improvement projects.
• Provides technical/directional guidance on examiner reports and claims adjudication.
• Compiles and analyzes management reports; takes appropriate action.
• Performs quality reviews to meet audit, service contract, and quality standards.
• Acts as second level of appeal for client and claimant issues; implements dispositions.

Skills

Leadership

Communication

Analytical skills

Organizational skills

Interpersonal skills

Negotiation

Teamwork

Problem solving

PC literacy

MS Office

Education

Bachelor's degree

Licenses/ Certifications as applicable

Tools

Microsoft Office

Job description

Absence Management Team Lead - Coding Team

PRIMARY PURPOSE: To supervise the operations of multiple teams of examiners and technical staff for disability claims, monitor workload, provide training, and oversee individual claim activities. The role provides technical direction to examiner reports, maintains claim diaries, and supports continuous improvement initiatives.

Essential Functions and Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties as appropriate.
• Identifies and advises management of trends, problems, and issues; recommends course of action and initiates process‑improvement projects.
• Provides technical and jurisdictional direction to examiner reports on claims adjudication.
• Compiles, reviews, and analyzes management reports and takes appropriate action.
• Performs quality reviews on claims to meet audit, service contract, and quality standards.
• Acts as second level of appeal for client and claimant issues, implementing final dispositions.
• Reviews reserve amounts on high‑cost claims and claims beyond the individual examiner’s authority.
• Monitors third‑party claims and maintains periodic reviews of litigated, vocational rehabilitation, questionable, and sensitive claims as determined by clients.
• Maintains client contact on claims, promotes professional relationships, and provides written resumes of specific claims as requested.
• Ensures direct reports are licensed in the serviced jurisdictions.
• Ensures claim files are coded correctly and documentation is adequate.

Additional Functions and Responsibilities

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

Supervisory Responsibilities

• Administers company personnel policies, staffing standards, and training recommendations.
• Interviews, hires, and establishes colleague performance development plans; conducts performance discussions.
• Provides support, guidance, leadership, and motivation to promote maximum performance.

Qualifications

• Bachelor's degree from an accredited college or university preferred; required licenses and professional certifications as applicable to the line of business.
• Six (6) years of claims experience or equivalent combination of education and experience required; two (2) years of claims supervisory experience preferred.
• Thorough knowledge of claims management procedures and processes for disability.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Leadership, management, and motivational skills.
• Analytical and interpretive skills.
• Strong organizational skills.
• Excellent interpersonal skills.
• Excellent negotiation skills.
• Ability to work in a team environment.
• Ability to meet or exceed performance competencies.

Work Environment

Consideration will be given to reasonable accommodations. The role requires clear conceptual thinking, excellent judgment, troubleshooting, problem solving, analysis, and discretion. Candidates must manage work‑related stress, handle multiple priorities simultaneously, and meet deadlines.

Legal Statements

The statements contained in this document describe the general nature and level of work performed by this position. They are not a comprehensive list of duties or local variations. Management retains discretion to add or change duties at any time.

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