Team Lead, Workers' Compensation Claims (Hybrid)

Sedgwick Claims Management Services Ltd; California; Hybrid; USD 105,000 - 118,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional/增长

Comprehensive benefits (medical,Dental

401K on day one

Job summary

Sedgwick, a global leader in claims management, seeks a California workers’ compensation professional with strong leadership and technical claims expertise to manage a team of examiners and support staff. The role focuses on adjudication quality, complex/high-exposure claims, and client service excellence.

Based in Brea, CA with a hybrid schedule (2 days in office, 3 days remote), you will guide claims adjudication, mentor staff, and ensure regulatory and documentation standards while

Qualifications

• 6 years of claims experience or equivalent education/experience preferred.
• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• California workers' compensation claim handling experience required; SIP Certified.

Responsibilities

• Supervises a team of examiners and technical operations colleagues, delegating duties and ensuring licensing/documentation.
• Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost/complex claims.
• Acts as second-level appeal authority for client and claimant issues and implements final decisions.
• 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 and provides written summaries as needed.
• Ensures accurate claim coding and documentation by examiners.

Skills

Leadership

Claims expertise

Client-focused

Education

High School Diploma

Bachelor's degree preferred

Professional certification as applicable

SIP Certified

Job description

Sedgwick, a global leader in claims management, seeks a California workers’ compensation professional with strong leadership and technical claims expertise to manage a team of examiners and support staff. The role focuses on adjudication quality, complex/high-exposure claims, and client service excellence.

Based in Brea, CA with a hybrid schedule (2 days in office, 3 days remote), you will guide claims adjudication, mentor staff, and ensure regulatory and documentation standards while