Claims Team Lead (Supervisor) Workers Compensation
Company: Sedgwick Claims Management Services, Inc
Location: Ontario
Posted on: January 12, 2021
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Job Description:
Claims Team LeadWorkers CompensationIF YOU CARE, THERE'S A PLACE
FOR YOU HEREFor a career path that is both challenging and
rewarding, join Sedgwick's talented team of 21,000 colleagues
around the globe. Sedgwick is a leading provider of
technology-enabled risk, benefits and integrated business
solutions. Taking care of people is at the heart of everything we
do. Millions of people and organizations count on Sedgwick each
year to take care of their needs when they face a major life event
or something unexpected happens. Whether they have a workplace
injury, suffer property or financial loss or damage from a natural
or manmade disaster, are involved in an auto or other type of
accident, or need time away from work for the birth of a child or
another medical situation, we are here to provide compassionate
care and expert guidance. Our clients depend on our talented
colleagues to take care of their most valuable assets -- their
employees, their customers and their property. At Sedgwick, caring
counts--. Join our team of creative and caring people of all
backgrounds, and help us make a difference in the lives of
others.For nearly 50 years, Sedgwick has been helping employers
answer virtually every question there is about workers'
compensation. We have experience in nearly every type of industry,
in every region, providing the broadest range of programs and
services.PRIMARY PURPOSE: To supervise the operation of multiple
teams of examiners and technical staff for workers compensation for
clients; to monitor colleagues' workloads, provide training, and
monitor individual claim activities; to provide
technical/jurisdictional direction to examiner reports on claims
adjudication; and to maintain a diary on claims in the teams
including frequent diaries on complex or high exposure
claims.ESSENTIAL FUNCTIONS and 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.ADDITIONAL
FUNCTIONS and RESPONSIBILITIES* Performs other duties as assigned.*
Supports the organization's quality program(s).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.QUALIFICATIONSEducation &
LicensingBachelor's degree from an accredited college or university
preferred. Licenses as required. Professional certifications as
applicable to line of business preferred.ExperienceSix (6) years of
claims experience or equivalent combination of education and
experience required to include two (2) years claims supervisor
experience.Skills & Knowledge* Thorough knowledge of claims
management processes and procedures for multiple product lines*
Excellent oral and written communication, including presentation
skills* PC literate, including Microsoft Office products*
Leadership/management/motivational skills* Analytical and
interpretive skills* Strong organizational skills* Excellent
interpersonal skills* Excellent negotiation skills* Ability to work
in a team environment* Ability to meet or exceed Performance
CompetenciesWORK ENVIRONMENTWhen applicable and appropriate,
consideration will be given to reasonable accommodations.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 deadlinesPhysical:
Computer keyboarding, travel as requiredAuditory/Visual: Hearing,
vision and talkingNOTE: Credit security clearance, confirmed via a
background credit check, is required for this position.The
statements contained in this document are intended to describe the
general nature and level of work being performed by a colleague
assigned to this description. They are not intended to constitute a
comprehensive list of functions, duties, or local variances.
Management retains the discretion to add or to change the duties of
the position at any time.Sedgwick--is an Equal Opportunity
Employerand aDrug-Free Workplace**Must currently meet the
requirements for designation under AB1262, or have California
Self-Insurers Certificate (SIP) or AB1262 California Experienced
Examiner Designation. WCCA, WCCP preferred.#LI-TS #monster
Keywords: Sedgwick Claims Management Services, Inc, Ontario , Claims Team Lead (Supervisor) Workers Compensation, Other , Ontario, California
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