Claims Team Lead Assistant - Workers Compensation | Roseville, CA

Job Title Claims Team Lead Assistant – Workers Compensation (Roseville, CA) Primary Purpose To analyze complex or technically difficult workers' compensation claims, determine benefits due, manage high‑exposure claims involving litigation and rehabilitation, and ensure ongoing adjudication within service expectations and industry best practices. Key Responsibilities Analyze and process complex workers' compensation claims; investigate and gather information to determine exposure. Manage claims through action plans toward timely resolution. Negotiate settlements within designated authority. Calculate and assign reserves; manage reserve adequacy through claim life cycle. Approve and make timely payments and adjustments; settle claims within authority level. Prepare necessary state filings within statutory limits. Manage litigation process; ensure timely and cost‑effective resolution. Coordinate vendor referrals for investigation or litigation management. Employ cost‑containment techniques through vendor partnerships. Manage claim recoveries (subrogation, second injury fund, Social Security, Medicare offsets). Report to excess carrier and respond to direction requests professionally. Communicate claim activity with claimant and client; maintain professional relationships. Ensure claim files are properly documented and coding is correct. Refer cases to supervisor as appropriate. Lead team meetings and assign accountability for follow‑up items. Assist in interview of adjusters, clerical staff, and provide feedback to hiring manager. Support team lead with monthly review of workloads, identify trends, and suggest adjustments. Additional Functions & Responsibilities Perform other duties as assigned. Support the organization’s quality program. Supervisory Responsibilities Administer company personnel policies in all areas and follow staffing standards and training recommendations. Interview, hire, and establish performance development plans for colleagues. Conduct performance discussions and provide support, guidance, leadership, and motivation. Qualifications Bachelor’s degree (preferred) from an accredited college or university. Professional certifications (applicable to line of business) preferred. Five (5) years of claims management or an equivalent combination of education and experience. California workers’ compensation claim handling experience. SIP certification (preferred). Work Environment & Compensation Flexible work schedule; hybrid work (Roseville, CA). Pay range $95,000–$105,000 per year. Benefits: medical, dental, vision, 401(k) with matching, PTO, disability, life insurance, employee assistance, flexible spending or health savings account, and additional voluntary benefits. EEO & Equal Opportunity Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. Qualified applicants with arrest or conviction records will be considered in accordance with applicable fair‑chance ordinances. #J-18808-Ljbffr