Remote Workers' Comp Claims Team Lead

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K on day one

PTO

Disability insurance

Life insurance

Employee assistance

FSA/HSA

Job summary

Sedgwick in Orange, CA is hiring a Workers' Compensation - Claims Team Lead to oversee multiple examiner teams and guide complex claim adjudication. The role emphasizes training, licensing compliance, and timely escalation of issues.

Ideal candidates bring several years of California workers' compensation experience, a high school diploma or higher, and relevant certifications. The position offers remote options within California and a comprehensive benefits package.

Qualifications

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

Responsibilities

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties and ensuring licensing and documentation.
• Provides 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.
• Identifies trends 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.
• Ensures accurate claim coding and documentation by examiners.

Skills

Claims experience

Supervisory experience

Claims adjudication

California WC

Education

High School Diploma

Bachelor's degree preferred

Professional certification

Job description

Sedgwick in Orange, CA is hiring a Workers' Compensation - Claims Team Lead to oversee multiple examiner teams and guide complex claim adjudication. The role emphasizes training, licensing compliance, and timely escalation of issues.

Ideal candidates bring several years of California workers' compensation experience, a high school diploma or higher, and relevant certifications. The position offers remote options within California and a comprehensive benefits package.