Hybrid Workers' Comp Claims Team Lead

Sedgwick; Brea (CA); Hybrid; USD 105,000 - 115,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

PTO

Disability and life insurance

Job summary

Sedgwick's Workers' Compensation Claims Team Lead position in Brea, CA offers a hybrid work model, leading examiners and technical staff to manage client claims across multiple industries. You’ll oversee workloads, provide training, and monitor activity while guiding adjudication and reserving practices.

This role emphasizes process improvement, client relationship management, and accurate coding, with a strong focus on licensing and jurisdiction knowledge, including SIP and California workers’

Qualifications

• 6 years of claims experience or equivalent combination of education and experience including two (2) years claims supervisor experience.
• 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.

Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
• Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
• Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
• Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
• Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
• Maintains professional client relationships, offering recommendations and written summaries as needed.
• Ensures accurate claim coding and documentation by examiners.

Skills

Team leadership

Training

Quality reviews

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick's Workers' Compensation Claims Team Lead position in Brea, CA offers a hybrid work model, leading examiners and technical staff to manage client claims across multiple industries. You’ll oversee workloads, provide training, and monitor activity while guiding adjudication and reserving practices.

This role emphasizes process improvement, client relationship management, and accurate coding, with a strong focus on licensing and jurisdiction knowledge, including SIP and California workers’