Claims Team Lead – Workers' Comp (CA)

Sedgwick; Providence (RI); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) on day one

Flexible work schedule

Career development

Job summary

Sedgwick is seeking a Claims Team Lead I with Workers' Compensation experience to supervise multiple examiner teams and drive client outcomes. This US remote role supports a nationwide client base and offers a path to leadership within a global insurer.

You'll mentor staff, monitor workloads, ensure accuracy, and provide technical direction on complex claims. Sedgwick emphasizes work-life balance, development opportunities, and a caring culture as part of its values.

Qualifications

• 5+ years of California Workers Compensation claims management experience or equivalent.
• Supervisory experience preferred.
• Bachelor's degree preferred.
• Licensure or professional certification as applicable to WC advisable.

Responsibilities

• Supervises multiple teams of examiners and staff for a wide span of control.
• Identifies trends and issues; recommends action and informs management.
• Provides technical/jurisdictional direction to examiner reports on claims adjudication.
• Compiles and analyzes management reports and takes action.
• Performs quality reviews to ensure audit and contract compliance.
• Acts as second-level appeal for client and claimant issues and handles disposition of appeals.
• Reviews reserve amounts on high-cost claims and beyond-authority cases.
• Maintains client contact and promotes a professional relationship.
• Ensures staff are properly licensed in serviced jurisdictions.
• Ensures claims files are coded correctly with adequate documentation.

Skills

Supervisory experience

Claims adjudication

Workers' compensation

Quality review

Client relationship management

Leadership

Education

High School Diploma or GED

Bachelor's degree preferred

Tools

Claims management software

Job description

Sedgwick is seeking a Claims Team Lead I with Workers' Compensation experience to supervise multiple examiner teams and drive client outcomes. This US remote role supports a nationwide client base and offers a path to leadership within a global insurer.

You'll mentor staff, monitor workloads, ensure accuracy, and provide technical direction on complex claims. Sedgwick emphasizes work-life balance, development opportunities, and a caring culture as part of its values.