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
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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