Claims Examiner - Workers Compensation Team Lead | Jurisdiction: CA or NV | Licensing: required

Sedgwick Claims Management Services Ltd; Phoenix (AZ); Hybrid; USD 100,000 - 115,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flexible spending or health savings

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation Team Lead to guide a team, manage claims, and ensure timely resolutions. This role emphasizes leadership, regulatory compliance, and delivering high-quality client service.

The position requires 5 years of claims management experience, CA licensing, and a strong commitment to Sedgwick's values and growth opportunities.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• Jurisdiction Knowledge/Licensing: CA.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
• Manages claims through well-developed action plans to an appropriate and timely resolution.
• Manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Leads team meetings and assigns accountability for follow-up items.

Skills

Claims management

Team leadership

Licensing CA

Regulatory knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

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 Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation Team Lead

Jurisdiction: CA or NV | Licensing: required

Role Overview

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Primary Purpose of the Role

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Essential Responsibilities May Include

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim
• Manages claims through well-developed action plans to an appropriate and timely resolution
• Manages the litigation process; ensures timely and cost-effective claims resolution
• Coordinates vendor referrals for additional investigation and/or litigation management
• Leads team meetings and assigns accountability for follow-up items
• Gathers important compliance/claims processing information to be presented at team meetings
• Assists in interviews of adjusters, clerical staff and provides feedback to hiring manager
• Provides limited assistance/support to team lead with monthly review of adjuster workloads; notes trends and suggests adjustments when necessary
• May include up to (3) three direct reports

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

• 5 years of claims management experience or equivalent combination of education and experience required
• High School Diploma or GED required
• Bachelor's degree from an accredited college or university preferred
• Professional certification as applicable to line of business preferred
• Jurisdiction Knowledge/Licensing: CA

Benefits

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

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Additional Perks

• Referral incentive program
• Career development and promotional growth opportunities
• Flexible work schedule

Work Environment Requirements

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

Auditory/Visual: Hearing, vision and talking

Compensation

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (100k-115k).

Eligibility and Equal Opportunity

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

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

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.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall.

For more, see sedgwick.com