Team Lead Claims Adjuster - Workers Compensation | Jurisdiction: TX, MN, MI | Licensing: TX or Home State required - Remote

Sedgwick Claims Management Services Inc.; Alabama; Hybrid; USD 69,000 - 97,000; Full time

Benefits offered by this job

Flexible work schedule

401K on day one

Medical, dental, vision

Job summary

Qualifications

• Bachelor's degree preferred.
• Six years of claims experience or equivalent.
• Two years of claims supervisor experience.

Responsibilities

• Supervises multiple teams of claims examiners and related staff.
• Provides technical direction for claims adjudication and reports.
• Performs quality reviews and ensures compliance with audit requirements.
• Maintains client relationships and communicates progress and issues.

Skills

Supervisory experience

Claims experience

Leadership

Education

Bachelor's degree

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance

Team Lead Claims Adjuster - Workers Compensation | Jurisdiction: TX, MN, MI | Licensing: TX or Home State required - Remote Team Lead Claims - Workers Compensation

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? Apply your adjuster and leadership knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

WORK LOCATIONS

Remote role

ESSENTIAL FUNCTIONS and 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.
• 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;
• 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires and establishes colleague performance development plans;
• Conducts colleague performance discussions.
• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS

• Education & Licensing: Bachelor's degree from an accredited college or university preferred.
• Licenses as required.
• Professional certifications as applicable to line of business preferred.
• Experience: Six (6) years of claims experience or equivalent combination of education and experience required.
• Include two (2) years claims supervisor experience.

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• [If Applicable] Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements include. When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Physical: Computer keyboarding, Auditory/Visual: Hearing, vision and talking. Note Employment may be contingent upon successful completion of a motor vehicle record (MVR) check, where job-related.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($69-97k).

A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims #LI-REMOTE

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

You may be just the right candidate for this or other roles. Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

For more, see sedgwick.com