Claims Team Lead

Sedgwick; Flagstaff (AZ); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote work

Job summary

Sedgwick is seeking a Claims Team Lead to supervise the property claims team and ensure high-quality adjudication for clients, with remote work in Arizona. The role emphasizes leadership, training, and process improvements to meet performance standards.

The ideal candidate brings extensive claims experience, strong analytical and communication skills, and the ability to manage workloads and client relationships across a distributed team.

Qualifications

• Bachelor's degree from an accredited college; Licenses as required.
• Six years of claims experience or equivalent.
• Strong leadership and communication skills.

Responsibilities

• Supervises the property claims team and related staff.
• Identifies trends and advises management on actions.
• Provides technical direction on claims adjudication.
• Reviews management reports and takes action.
• Performs quality reviews to meet audit standards.
• Acts as second level appeal for client issues.
• Reviews reserve amounts on high-cost claims.
• Maintains client contact and professional relationships.
• Ensures staff are properly licensed.
• Ensures claims files are properly coded and documented.

Skills

Claims management

Leadership

Communication skills

Analytical skills

MS Office

Education

Bachelor's degree

Tools

MS Office

Job description

Telecommuter AZ

Full time

R79299

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 Team Lead

PRIMARY PURPOSE

To supervise the operation of the property team and technical staff for property claims of our clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Supervises the property claims team and/or several (minimum four) 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 colleagues.

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 & Licensing

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of businesses preferred.

Experience

Six (6) years of claims experience or equivalent combination of education and experience.

Skills & Knowledge

• Thorough knowledge of claims management processes and procedures for multiple product lines




• Excellent oral and written communication, including presentation skills




• PC literate, including Microsoft Office products




• Leadership/management/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

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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! 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. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com