Sedgwick

Sedgwick, headquartered in Memphis, Tennessee, provides a global clientele with technology-enabled risk and benefits solutions. Distinguished as an Employer of

Claims Team Lead – General Liability

Location

Louisiana

Posted

4 days ago

Salary

0

Seniority

Senior

High School6 yrs expEnglish

Job Description

Claims Team Lead – General Liability

Sedgwick

• To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; • To monitor colleagues' workloads, provide training, and monitor individual claim activities; • To provide technical/jurisdictional direction to examiner reports on claims adjudication; • To maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. • Identifies and advises management of trends, problems, and issues as well as recommended course of action. • 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; • 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.

Job Requirements

  • 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.
  • Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

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.

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