Workforce Absence Team Lead

Primary Purpose Supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; monitor workload, provide training, give technical direction to examiner reports, and maintain claim diaries. Essential Functions and Responsibilities Supervise multiple teams of examiners and technical operations colleagues, delegating duties as appropriate. Identify and advise management of trends, problems, and issues; recommend actions and coordinate improvement projects. Provide technical and jurisdictional direction to examiner reports on claims adjudication. Compile, review, and analyze management reports, taking appropriate action. Perform quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards. Act as a second level of appeal for client and claimant issues, implementing final dispositions. Review reserve amounts on high-cost claims and claims above individual examiner authority. Monitor third-party claims and periodically review litigated, vocational rehabilitation, questionable, and sensitive claims as directed by the client. Maintain contact with the client, promote professional relationships, and provide written updates on specific claims. Ensure direct reports are properly licensed in the serviced jurisdictions. Ensure claims files are coded correctly and adequately documented by examiners. Additional Functions and Responsibilities Perform other duties as assigned. Support the organization's quality program(s). Supervisory Responsibilities Administer company personnel policies and follow staffing standards and training recommendations. Interview, hire, and establish colleague performance development plans; conduct performance discussions. Provide support, guidance, and leadership to promote maximum performance. Qualifications Bachelor's degree from an accredited college or university (preferred). Required licenses; professional certifications as applicable to the line of business (preferred). 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 claims. Excellent oral and written communication, including presentation skills. PC literate, proficient with Microsoft Office. Leadership, management, and motivational skills. Analytical and interpretive skills. Strong organizational skills. Excellent interpersonal and negotiation skills. Ability to work in a team environment. Performance orientation, meeting or exceeding expectations. Work Environment Reasonable accommodations may be considered. Physical work includes computer keyboarding and occasional travel. Mental demands include critical thinking, judgment, problem solving, and handling multiple priorities and deadlines. Auditory/visual demands: hearing, vision, speaking. sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

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