Hybrid Workers’ Comp Claims Team Lead

Sedgwick; Brea (CA); Hybrid; USD 105,000 - 118,000; Full time

Benefits offered by this job

Flexible work schedule

Career development opportunities

Comprehensive benefits package (health

Job summary

Sedgwick is seeking a Claims Team Lead for Workers Compensation in Brea, CA. The role is hybrid (2 days in office, 3 days remote) and leads a team handling complex WC claims for a key client, providing expert adjudication guidance and jurisdictional insight.

You will mentor staff, drive quality reviews, manage high-exposure files, and ensure accurate coding and documentation while maintaining strong client relationships. Sedgwick offers development and a comprehensive benefits package.

Qualifications

• 6 years of claims experience or equivalent education/experience preferred.
• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Supervises a team 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

Claims adjudication

Client relationship management

California WC knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Team Lead for Workers Compensation in Brea, CA. The role is hybrid (2 days in office, 3 days remote) and leads a team handling complex WC claims for a key client, providing expert adjudication guidance and jurisdictional insight.

You will mentor staff, drive quality reviews, manage high-exposure files, and ensure accurate coding and documentation while maintaining strong client relationships. Sedgwick offers development and a comprehensive benefits package.