Workers Compensation Claims Team Lead | Dedicated Client | Jurisdictions: DE, IL, LA,MO,NJ,OK,TN, TX | License: Required

Before you apply

Job source

Workday

Applying on

sedgwick.wd1.myworkdayjobs.com

Workplace

Fully remote

US state

AL

Category

Virtual Assistant

Link last checked

2 hours ago

Posted

20 hours ago

Closes

No stated closing date

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About the role

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 Workers Compensation Claims Team Lead | Dedicated Client | Jurisdictions: DE, IL, LA,MO,NJ,OK,TN, TX | License: Required 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 Workers Compensation & supervisory 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. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure liability claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; to identify subrogation of claims and negotiate settlements; and to provide backup for team lead when out of the office. PRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, 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 in the teams including frequent diaries on complex or high exposure claims. 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; 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 clai

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