Claims Team Lead Asst - Workers Compensation

Sedgwick Claims Management Services Ltd; Honolulu (HI); On-site; USD 85,000 - 94,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Job summary

Sedgwick is hiring for a Claims Team Lead Asst - Workers Compensation in Honolulu, HI. You will analyze complex workers' compensation claims, determine benefits due, work with high-exposure cases, and support team leadership in adjudication and settlement negotiations.

The role requires five years of claims management experience, an Hawaii license for workers' comp claims handling, and a background in managing litigation and subrogation as needed.

Qualifications

• Bachelor's degree preferred
• Five (5) years claims management experience
• Hawaii License & workers comp claims handling experience

Responsibilities

• Analyzes and processes complex workers’ compensation claims by investigating and gathering information
• Manages claims through action plans to resolution
• Negotiates settlements within designated authority
• Calculates and assigns reserves to claims and monitors reserve adequacy
• Calculates and pays benefits due and handles claim payments
• Prepares state filings within statutory limits
• Manages litigation process for cost-effective resolution

Education

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 Team Lead Asst - Workers Compensation

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.

OFFICE LOCATIONS: HONOLULU, HAWAII

PRIMARY PURPOSE OF THE ROLE

To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure workers' compensation claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; to identify subrogation of claims and negotiate settlements; and to provide backup for team lead when out of the office.

ESSENTIAL 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
• Negotiates settlement of claims within designated authority
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy through the life of the claim
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; settles claims within designated authority level
• Prepares necessary state filings within statutory limits
• Manages the litigation process; ensures timely and cost effective claims resolution

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

• Bachelor's degree from an accredited college or university preferred
• Professional certifications as applicable to line of business preferred
• Five (5) years claims management or equivalent combination of education and experience required
• Licensing / Jurisdiction Knowledge: Hawaii License & workers comp claims handling experience

TAKING CARE OF YOU

• Flexible work schedule
• Referral incentive program
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one

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 as required by law

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 $85K-$94K/yr.

BENEFITS

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

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.

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