Claims Team Lead, Auto | PIP

Sedgwick Claims Management Services Ltd; Texas; Hybrid; USD 90,000 - 130,000; Full time

Job summary

Sedgwick Claims Management Services Ltd seeks a Claims Team Lead for Auto/PIP who will supervise examiner teams and technical staff, monitor workloads, and provide training and jurisdictional direction on claims adjudication. The role emphasizes quality, client communication, and process improvement across multiple product lines.

The candidate will oversee performance, review claims, and ensure compliance with audit standards while maintaining strong client relationships and staff development in

Qualifications

• Six years of claims experience or equivalent combination, including two years as a supervisor.

Responsibilities

• Supervises multiple teams of examiners and technical staff for a wide span of control.
• Monitors workloads and provides training and direction on claims adjudication.
• Performs quality reviews to ensure audits and contract requirements.
• Acts as second level of appeal for client and claimant issues; documents dispositions.
• Maintains client relationships and provides written summaries of claims as requested.
• Ensures reports are properly licensed by jurisdictions served.

Skills

Claims management

Leadership

Oral and written communication

Analytical thinking

Organizational skills

Negotiation skills

Teamwork

Education

Bachelor's degree

Claims licensing (as applicable)

Tools

Microsoft Office

Job description

## Claims Team Lead, Auto | PIPApply: Telecommuter TX: Posted Today: R77583By 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 CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Auto | PIP**PRIMARY PURPOSE OF THE ROLE** To supervise the operation of personal injury protection examiner teams and technical staff for clients, monitors colleagues' workloads, provide training, and monitor individual claim activities, and to provide technical/jurisdictional direction to examiner reports on claims adjudication.**ESSENTIAL RESPONSIBILITIES OF THE ROLE MAY INCLUDE*** Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) 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.* 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 examiners.**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:** Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.* Bachelor's degree from an accredited college or university preferred.* Licenses as required.* Professional certifications as applicable to line of business preferred.**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 product* 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 CompetenciesThe 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.