Remote Claims Team Lead I – Workers' Comp (CA)

Sedgwick; Honolulu (HI); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development opportunities

Comprehensive benefits package

Job summary

Sedgwick is seeking a Claims Team Lead I to supervise multiple examiner teams handling workers’ compensation for clients, including complex claims oversight and diary management. This telecommuter role requires California WC knowledge and strong leadership to drive performance in a remote, global environment.

We offer a flexible work schedule, ongoing development, and a comprehensive benefits package. Equal opportunity employer and career growth opportunities are highlighted in this role.

Qualifications

• Education & Licensing: 5 years of California Workers Compensation claims management experience or equivalent combination of education and experience required.
• Supervisory Experience Preferred
• Jurisdiction Knowledge: California

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.
• 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.

Education

High School Diploma or GED

Bachelor's degree preferred

California workers' compensation claims experience

Job description

Sedgwick is seeking a Claims Team Lead I to supervise multiple examiner teams handling workers’ compensation for clients, including complex claims oversight and diary management. This telecommuter role requires California WC knowledge and strong leadership to drive performance in a remote, global environment.

We offer a flexible work schedule, ongoing development, and a comprehensive benefits package. Equal opportunity employer and career growth opportunities are highlighted in this role.