California Workers' Comp Claims Team Lead

Sedgwick; Roseville (CA); Hybrid; USD 100,000 - 118,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits including 401K,

Job summary

Sedgwick is hiring a Claims Team Lead - Workers' Compensation in California. This hybrid role oversees a team of workers' compensation claim examiners and technical staff, ensuring accurate adjudication and timely client updates across multiple office locations.

Ideal candidates have strong California WC expertise, a track record in supervising examiners, and the ability to guide complex, high-exposure claims while driving process improvements and professional development.

Qualifications

• Bachelor's degree preferred; licenses as required.
• SIP certification required or must be obtained within one year of hire date.
• Six years of California workers' compensation claims management experience or equivalent.

Responsibilities

• Supervises a team of workers' compensation claims examiners and technical staff; may delegate duties.
• Identifies trends and issues; suggests actions and coordinates with management.
• 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 per audit, service contract and quality standards.
• Acts as second level of appeal; implements final disposition of the appeal.
• Reviews reserve amounts on high-cost claims and those beyond examiner authority.
• Monitors third party claims; reviews litigated, rehab, and sensitive claims as needed.
• Maintains client contact on claims and provides written resumes of claims as requested.
• Ensures files are coded correctly and documentation is adequate by examiners.

Education

Bachelor's degree

Licenses as required

SIP certification within 1 year

Job description

Sedgwick is hiring a Claims Team Lead - Workers' Compensation in California. This hybrid role oversees a team of workers' compensation claim examiners and technical staff, ensuring accurate adjudication and timely client updates across multiple office locations.

Ideal candidates have strong California WC expertise, a track record in supervising examiners, and the ability to guide complex, high-exposure claims while driving process improvements and professional development.