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.
As an Absence Management Team Lead - Coding Team, your primary purpose will be to 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
- 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, 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
- Review reserve amounts on high cost claims and claims over the authority of the individual examiner
- Monitor third party claims and maintain periodical review of litigated claims
- Maintain contact with the client on claims and promote a professional client relationship
- 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
- 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