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're looking for a driven individual to lead our Workers Compensation Team, embodying our caring counts model and core values of empathy, accountability, collaboration, growth, and inclusion.
Primary Purpose of the Role: Supervise multiple teams of examiners and technical staff for workers compensation for clients; monitor colleagues' workloads, provide training, and monitor individual claim activities; provide technical/jurisdictional direction to examiner reports on claims adjudication; and maintain a diary on claims in the teams.
Essential Responsibilities May Include:
- Supervise multiple teams of examiners, multiple product line examiners and/or several technical operations colleagues
- Identify and advise management of trends, problems, and issues as well as recommended course of action
- Provide technical/jurisdictional direction to examiner reports on claims adjudication
- Compile reviews and analyze management reports and take appropriate action
- Perform quality review on claims in compliance with audit requirements, service contract requirements, and quality standards
- Act as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests
- Review reserve amounts on high cost claims and claims over the authority of the individual examiner
- Monitor third party claims; maintain periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client
- Maintain contact with the client on claims and promote a professional client relationship; make recommendations to client as suggested by the claim status; and provide written resumes of specific claims as requested by client
- Assure that direct reports are properly licensed in the jurisdictions serviced
- Ensure claims files are coded correctly and adequate documentation is made by claims examiners
Supervisory Responsibilities:
- Administer company personnel policies in all areas and follow company staffing standards and training recommendations
- Interview, hire and establish colleague performance development plans; conduct colleague performance discussions
- Provide support, guidance, leadership and motivation to promote maximum performance
Travel: Occasional travel to Media, PA for onsite client meetings
Qualifications:
- Bachelor's degree from an accredited college or university preferred
- Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience
- Jurisdiction Knowledge: Heavy NJ & PA, some FL
- Licensing: Not Required
Benefits:
- Flexible work schedule
- Referral incentive program
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one