Claims Team Lead - Workers Compensation (CA)

About the role

Sedgwick is hiring a Claims Team Lead for workers compensation claims in California. The role supervises a team of claims examiners and technical staff, monitors their workloads, provides training and technical direction on claims adjudication, and keeps track of complex or high-exposure claims. It is a hybrid position with several California office locations available.

Key responsibilities

• Supervise a team of workers compensation claims examiners and technical staff, delegating some duties within the unit
• Identify trends, problems and issues, advise management and coordinate with management projects for continuous improvement
• Provide technical and jurisdictional direction to examiner reports on claims adjudication
• Review reserve amounts on high-cost claims and claims beyond an examiner's authority, and monitor third-party and litigated claims
• Act as second-level appeal for client and claimant issues and implement final dispositions
• Perform quality reviews of claims against audit, service contract and quality standards
• Maintain contact with the client, recommend actions based on claim status 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
• Interview, hire and coach colleagues, administer personnel policies and follow staffing standards

Required profile

• Bachelor's degree from an accredited college or university preferred
• California workers' compensation claims management experience: six years total, including two years as a claims supervisor
• California jurisdictional knowledge and SIP certification required, or must be obtained within one year of hire
• Licenses as required and professional certifications preferred

What we offer

• Flexible work schedule and referral incentive program
• Career development and promotion opportunities
• Medical, dental, vision, 401K on day one, PTO, disability and life insurance, and other benefits
• Starting pay range of $100,000 - $118,000 for this role