Claims Team Lead Workers Compensation I Remote I Central Region Position Available In Kennebec, Maine

Claims Team Lead Workers Compensation I Remote I Central Region at Sedgwick in Augusta, Maine, United States Job Description 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 Claims Team Lead Workers Compensation I Remote I Central Region

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 requeste