Claims Team Lead, Auto | PIP

Location: Telecommuter TX

Job Description

By joining Sedgwick, youll 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, Auto | PIP

PRIMARY PURPOSE OF THE ROLE To supervise the operation of personal injury protection examiner teams and technical staff for clients, monitors colleagues workloads, provide training, and monitor individual claim activities, and to provide technical/jurisdictional direction to examiner reports on claims adjudication.

ESSENTIAL RESPONSIBILITIES OF THE ROLE MAY INCLUDE

• 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.

• 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 requested by client.

• Assures that direct reports are properly licensed in the jurisdictions serviced.

• Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS
Education & Licensing: Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

• Bachelors degree from an accredited college or university preferred.

• Licenses as required. 

• Professional certifications as applicable to line of business preferred.

Skills & Knowledge

• Thorough knowledge of claims management processes and procedures for multiple product lines

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office product

•  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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If youre excited about this role but your experience doesnt align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.