Remote Auto & PIP Claims Team Lead

Sedgwick; Houston (TX); Remote; USD 85,000 - 110,000; Full time

Job summary

Sedgwick is seeking a Claims Team Lead, Auto | PIP to supervise examiner teams and provide jurisdictional direction on claims adjudication. You will monitor workloads, train staff, and ensure quality aligned with audit standards.

You will lead reviews, develop process improvements, and maintain strong client relationships while ensuring licensing and documentation compliance across jurisdictions.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Leadership/Management

Communication

Analytical skills

Teamwork

Negotiation

MS Office

Organization

Interpersonal skills

Claim knowledge

Education

Bachelor's degree preferred

Licenses as required

Professional certifications preferred

Tools

Microsoft Office

Job description

Sedgwick is seeking a Claims Team Lead, Auto | PIP to supervise examiner teams and provide jurisdictional direction on claims adjudication. You will monitor workloads, train staff, and ensure quality aligned with audit standards.

You will lead reviews, develop process improvements, and maintain strong client relationships while ensuring licensing and documentation compliance across jurisdictions.