Absence Management Team Lead - Coding Team

About the role

Sedgwick is hiring an Absence Management Team Lead for its coding team in Dubuque. The role supervises multiple teams of examiners and technical staff handling disability claims for clients, monitors workload, provides training and technical direction on claims adjudication, and keeps a diary on claims, especially complex or high-exposure ones.

Key responsibilities

• Supervise multiple teams of examiners and technical staff, possibly delegating some duties within the unit
• Identify trends, problems and issues, advise management and coordinate with management projects
• Provide technical and jurisdictional direction to examiner reports on claims adjudication
• Review and analyze management reports, perform quality reviews of claims against audit, service contract and quality standards
• Act as second-level appeal for client and claimant issues and implement the final disposition
• Review reserve amounts on high-cost claims and claims beyond an examiner's authority
• Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable and sensitive claims
• Maintain contact with the client, make recommendations and provide written summaries of specific claims
• Ensure direct reports are properly licensed in the jurisdictions served and that claims files are coded correctly with adequate documentation
• Support the organization's quality programs and administer company personnel policies, including hiring, performance plans and coaching

Required profile

• Bachelor's degree from an accredited college or university preferred
• Licenses as required and professional certifications preferred
• Six years of claims experience or an equivalent combination of education and experience; two years of claims supervisory experience preferred

Required skills

• Thorough knowledge of claims management procedures and processes for disability
• Oral and written communication, including presentation skills
• PC literacy, including Microsoft Office
• Analytical, organizational and interpersonal skills, and strong negotiation skills