Workforce Absence Team Lead - Claims Assistant Team

Sedgwick Claims Management Services Ltd; Dubuque (IA); On-site; USD 65,000 - 90,000; Full time

Job summary

Sedgwick Claims Management Services Ltd is seeking a licensed supervisor to oversee multiple teams of examiners handling disability claims. You will monitor workloads, train staff, and provide technical direction on adjudication, ensuring compliance with audits and client needs.

The role requires strong leadership, extensive claims experience, and the ability to manage complex, high-exposure cases while maintaining documentation and professional client relationships across the organization.

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 preferred; licenses as required.

Responsibilities

• Supervises multiple teams of examiners and technical staff for disability claims.
• Monitors workload, provides training, and directs examiner reports.
• Performs quality review on claims in compliance with audit and client requirements.
• Acts as second level of appeal and handles complex or high exposure claims.
• Maintains client relations and ensures proper documentation and licensing.

Skills

Leadership

Claims management

Quality review

Analytical skills

Communication

Education

Bachelor's degree

Tools

Microsoft Office

Job description

PRIMARY 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 RESPONSIBILITIES

Supervises 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 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. Two (2) years of claims supervisory experience preferred.

Skills & Knowledge

Thorough knowledge of claims management procedures and processes for disability. Excellent oral and written communication, including presentation skills. PC literate, including Microsoft Office products. Leadership/management/motivational skills. Analytical and interpretive skills. Strong organizational skills. Excellent interpersonal skills. Excellent negotiation skills. Ability to work in a team environment. Ability to meet or exceed performance competencies.

WORK ENVIRONMENT

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, travel as required. Auditory/Visual: Hearing, vision and talking.

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 Workforce Absence Team Lead - Claims Assistant Team

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. 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.