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 Liability Claims Team on the East Coast States, specifically in Marlton, NJ with a hybrid schedule (2 days in-office).
Primary Purpose of the Role: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
Essential Responsibilities May Include:
- Supervise 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.
- 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 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; 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 the client.
- Maintain contact with the client on claims and promote a professional client relationship; make recommendations to the client as suggested by the claim status; and provide written resumes of specific claims as requested by the 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.
Qualifications:
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certifications as applicable to the line of business preferred.
- Six (6) years of claims experience or equivalent combination of education and experience required, including two (2) years of claims supervisor experience.
- Jurisdiction Knowledge: East Coast - heavy NJ & PA.
- Licensing: not required.
Taking Care of You:
- 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.
Work Environment Requirements:
- 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.
- Auditory/Visual: Hearing, vision, and talking.