Workers Compensation Claims Team Lead | MD, VA, DC, WV, DE Jurisdictional Knowledge | WV & DE L[...]

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 Position Title Workers Compensation Claims Team Lead | MD, VA, DC, WV, DE Jurisdictional Knowledge | WV & DE Licensing Core Responsibilities 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. Essential 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 claims as requested by client. Assures that direct reports are properly licensed in the jurisdictions serviced. Ensures claims files are coded correctly and adequate documentation is made by claims examiners. Supervisory Responsibilities Administers company personnel policies in all areas and follows company staffing standards and training recommendations. Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions. Provides support, guidance, leadership and motivation to promote maximum performance. Qualifications 5 years of claims management experience or an equivalent combination of education and experience. High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Jurisdiction Knowledge: MD, VA, DC, WV, DE. Licensing: WV & DE. Benefits Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one. Work Environment Requirements Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work‑related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Physical: Computer keyboarding. Auditory/Visual: Hearing, vision and talking. When applicable and appropriate, consideration will be given to reasonable accommodations. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($85 - $97K). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement