Remote Workers' Comp Claims Team Lead (NV)

Sedgwick; Pierre (SD); Remote; USD 80,000 - 106,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits

Job summary

Sedgwick is seeking a Claims Team Lead for Workers' Compensation with NV jurisdiction and remote work options. The role supervises multiple examiners and technical staff, ensuring compliant claims adjudication and timely workflows for clients across industries.

You will monitor workloads, provide training, and review reports while acting as a second level of appeal on complex claims. Flexible schedule, growth opportunities, and comprehensive benefits are included.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

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.
• 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.
• Ensures claims files are properly licensed in the jurisdictions serviced.
• Performs other duties as assigned.
• Supports the organization’s quality program(s).

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

Sedgwick is seeking a Claims Team Lead for Workers' Compensation with NV jurisdiction and remote work options. The role supervises multiple examiners and technical staff, ensuring compliant claims adjudication and timely workflows for clients across industries.

You will monitor workloads, provide training, and review reports while acting as a second level of appeal on complex claims. Flexible schedule, growth opportunities, and comprehensive benefits are included.