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.
Job Summary: As a Workforce Absence Team Lead, you will supervise the operations of multiple teams of examiners and technical staff for disability claims for clients. You will monitor colleagues' workload, provide training, and monitor individual claim activities. You will also provide technical/jurisdictional direction to examiner reports on claims adjudication and maintain a diary on claims within the teams.
Responsibilities:
- Supervise multiple teams of examiners and/or several technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
- Identify and advise management of trends, problems, and issues as well as recommended course of action; inform management of new procedures and ideas for continuous process improvement; and coordinate with management projects for the office.
- Provide technical/jurisdictional direction to examiner reports on claims adjudication.
- Compile, review, 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; implement final disposition of the appeal.
- 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.
Additional Responsibilities:
- Perform other duties as assigned.
- Support the organization's quality program(s).
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.
Qualifications:
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required. Professional certifications as applicable to line of business preferred.
- Six (6) years of claims experience or equivalent combination of education and experience required.
- Two (2) years of claims supervisory experience preferred.
Skills & Knowledge:
- Thorough knowledge of claims management procedures and processes for disability
- 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 Competencies
Work Environment:
- When 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 deadlines
Physical:
- Computer keyboarding, travel as required
Auditory/Visual:
- Hearing, vision and talking
Salary: The range of starting pay for this role is $57,000.00 - $67,000.00. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.