Workforce Absence Team Lead

Sedgwick Claims Management Services Ltd; Dublin (OH); On-site; USD 65,000 - 95,000; Full time

Job summary

Sedgwick Claims Management Services Ltd is seeking a Senior Supervisor to oversee multiple teams of claims examiners for disability claims. You will monitor workloads, provide training, and give technical direction on adjudication while ensuring high-quality controls and timely client updates.

The role requires extensive claims experience and at least some supervisory background, with a focus on process improvement and regulatory compliance within a large, client-facing environment.

Qualifications

• Six (6) years of claims experience or equivalent combination of education and experience required.
• Two (2) years of claims supervisory experience preferred.
• Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

Responsibilities

• Supervises multiple teams of examiners and/or several technical operations colleagues.
• Monitors workload and provides training and direction to examiner reports on claims adjudication.
• Performs quality reviews and analyzes management reports to inform action.
• Acts as second level of appeal for client and claimant issues and manages disposal of appeals.
• Maintains client relationships and communicates claims status and recommendations.
• Ensures licensing requirements are met and claims files are properly documented.

Skills

Claims experience

Leadership

Communication

Analytical skills

Organizational skills

Problem solving

Education

Bachelor's degree

Tools

Microsoft Office

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 CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceWorkforce Absence Team LeadPRIMARY PURPOSE : To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims.ESSENTIAL FUNCTIONS and RESPONSIBILITIESSupervises multiple teams of examiners and/or several 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.ADDITIONAL FUNCTIONS and RESPONSIBILITIESPerforms other duties as assigned.Supports the organization's quality program(s).SUPERVISORY RESPONSIBILITIESAdministers 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.QUALIFICATIONSEducation & LicensingBachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.ExperienceSix (6) years of claims experience or equivalent combination of education and experience required. Two (2) years of claims supervisory experience preferred.Skills & KnowledgeThorough knowledge of claims management procedures and processes for disabilityExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsLeadership/management/motivational skillsAnalytical and interpretive skillsStrong organizational skillsExcellent interpersonal skillsExcellent negotiation skillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen 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 deadlinesPhysical : Computer keyboarding, travel as requiredAuditory/Visual : Hearing, vision and talkingThe statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.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.