Sedgwick

Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CA

Sedgwick$100K — $115K *
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 6 years of claims experience or equivalent education and experience; 2 years must include supervisory experience
  • High School Diploma or GED required; Bachelor's degree preferred
  • California workers compensation claim handling experience
  • SIP Certified preferred
  • Strong analytical and problem-solving skills

Responsibilities

  • Supervise and delegate tasks to teams of examiners and staff
  • Provide technical guidance on claims adjudication and ensure quality reviews
  • Act as the second-level appeal authority for claims-related issues
  • Identify trends and opportunities for process improvements
  • Monitor sensitive and litigated claims effectively
  • Maintain strong client relationships through communication and summary reports
  • Ensure accuracy in claim coding and documentation

Benefits

  • Flexible work schedule
  • Referral incentive program
  • Career development and growth opportunities
  • Comprehensive benefits including medical, dental, vision, and 401K starting day one
Full Job Description
Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CA

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  

  • Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. 

  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. 

  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 

  • Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. 

  • Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. 

  • Enjoy flexibility and autonomy in your daily work, your location, and your career path. 

  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATIONS

Roseville, CA or San Diego, CA - Hybrid (2 days onsite)

PRIMARY PURPOSE OF THE ROLE: Oversees examiners handling workers compensation claims for a dedicated client. Manages workloads, provides training, and monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex or high-exposure case.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Supervises examiners, delegating duties as needed and ensuring proper licensing and documentation standards.

  • Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.

  • Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.

  • Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.

  • Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.

  • Maintains professional client relationships, offering recommendations and written summaries as needed.

  • Ensures accurate claim coding and documentation by examiners.

QUALIFICATIONS

Education & Licensing: 6 years of California Workers Compensation claims experience required. 2 years of supervisory experience preferred.

Licensing / Jurisdiction Knowledge: California workers compensation claim handling experience | SIP Certified

TAKING CARE OF YOU

  • Flexible work schedule. 

  • Referral incentive program. 

  • Career development and promotional growth opportunities. 

  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

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

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $100,000-$115,000/yr. 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.

#LI-Hybrid #claims #claimsteamlead #LI-Remote

About Sedgwick

Sedgwick is a global provider of insurance, risk management, and related services. The company was founded in 1969 and is headquartered in Boston, Massachusetts. Sedgwick offers a range of services to clients in various industries, including property and casualty insurance, workers' compensation, and disability management. The company has a team of experienced professionals who work closely with clients to develop customized solutions that meet their specific needs. Sedgwick has a reputation for delivering high-quality service and has been recognized for its excellence in the insurance industry.
Learn more about Sedgwick
Size
10,000 employees
Industry
Founded
1969

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