Claims Team Lead - Workers Compensation (Nevada)

About the role

Sedgwick is hiring a Claims Team Lead for workers compensation in Nevada. The role supervises multiple teams of examiners and technical staff, monitors their workloads, provides training and technical direction on claims adjudication, and keeps track of claims in team diaries, including complex or high-exposure claims.

Key responsibilities

• Supervise multiple teams of examiners, product line examiners and technical operations colleagues (at least seven); may delegate some duties.
• Identify trends, problems and issues, advise management and coordinate improvement projects.
• Provide technical and jurisdictional direction to examiner reports on claims adjudication.
• Review and analyze management reports, and 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, vocational rehabilitation, questionable and sensitive claims.
• Maintain contact with the client, make recommendations and provide written claim summaries.
• 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 personnel policies, including hiring, performance plans and coaching.

Required profile

• High school diploma or GED required; bachelor's degree preferred.
• Six years of claims experience or equivalent combination, including two years as a claims supervisor.
• Nevada licensing and jurisdiction knowledge required.
• Professional certification for the line of business preferred.

What we offer

• Starting pay range of $80,000 to $106,000 for this Nevada role.
• Flexible work schedule, referral incentive program and career development opportunities.
• Medical, dental, vision, 401K, PTO, disability and life insurance, and other benefits.