Remote Claims Team Lead

Sedgwick; Memphis (TN); A distancia; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

Sedgwick is seeking a seasoned claims supervisor to oversee multiple examination teams handling liability claims for clients. You will monitor workloads, train staff, and provide technical direction on adjudication while keeping detailed diaries on complex cases.

The role requires at least six years of claims experience, with two years in supervision. Bachelor's degree preferred; licenses and professional certifications may be required. Strong leadership and communication skills are essential.

Formación

• 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.

Responsabilidades

• Supervises multiple teams of examiners, multiple bodily injury and property damage 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.
• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
• Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
• 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.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Conocimientos

Claims management

Oral & written communication

Microsoft Office

Leadership

Analytical skills

Organizational skills

Interpersonal skills

Negotiation skills

Teamwork

Performance competencies

Educación

Bachelor's degree

Herramientas

Microsoft Office

Descripción del empleo

Sedgwick is seeking a seasoned claims supervisor to oversee multiple examination teams handling liability claims for clients. You will monitor workloads, train staff, and provide technical direction on adjudication while keeping detailed diaries on complex cases.

The role requires at least six years of claims experience, with two years in supervision. Bachelor's degree preferred; licenses and professional certifications may be required. Strong leadership and communication skills are essential.