- 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.
- Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
- Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
- 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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- 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.
- 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 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
-
Lead / Assistant Teacher
1 day ago
Abacus Early Learning Center Westfield, United StatesAbacus Early Learning Centers are a private, family-owned business that has been providing top quality childcare for over 35 years. Our purpose is to be a trusted partner in raising great kids Our centers are Paths to Quality Level 4 and NECPA Accredited. Our staff are profession ...
-
Lead and Assistant Infant Room Teachers
2 weeks ago
THE GODDARD SCHOOL - NEWTOWN, PA Newtown, United StatesJob Description · Job DescriptionThe Goddard School a leader in early childhood care and education, is looking for full-time Lead and Assistant Infant Room Teachers for our award winning school in Newtown, PA. This is a great opportunity to be part of a Department of Education ce ...
-
Assistant Team Lead
4 days ago
Sedgwick Hartford, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or City and state must be separated by a comma followed by a space (e.g., Houston, TX )Sedgwick Assistant Team Lead in Hartford , Connecticut Taking care of people is at the heart ...
-
Lead Medical Assistant
1 week ago
Trinity Health Springfield, United StatesEmployment Type: · Full time · Shift: · Rotating Shift · Description: · Position Purpose · This person is responsible for helping lead the team of Medical Assistants who are preparing patients for office visits, performing tasks including escorting patient to treatment rooms, obt ...
-
LEAD Quality Inspector
3 weeks ago
Bombardier Windsor, United States Full timeAt Bombardier, our employees work together to evolve mobility worldwide - one good idea at a time. If you have a good idea, we'll provide the environment where it will thrive and grow into a great product or customer experience. Your ideas are our fuel. · In a working capacity an ...
-
Dental Hygienist
6 days ago
Aspen Dental New Hartford, United States Full timeAt Aspen Dental, we put You 1st with world-class development plus industry-leading pay. Join our team today as a Dental Hygienist · Job Types: Full-time, Part-time · Salary: · $72,000 - $83,000 per year (annualized base salary + incentive earnings, based on full time schedule) · ...
-
Bench Assistant Deli Team Lead
2 weeks ago
Price Chopper, Market 32 & Market Bistro Middletown, United StatesProvides fast, friendly, helpful and efficient service to all Price Chopper Customers. Responsible for providing a neat and clean deli operation in accordance with all corporate and state sanitation guidelines. Responsible for ordering product and ke Team Lead, Deli, Deli Manager ...
-
Junior Copywriter
3 weeks ago
Engineering Services and Products Company South Windsor, United StatesThe start of a rewarding career awaits you at Engineering Services & Products Company (ESAPCO). Since 1979, we've grown from a regional, two-person office to the industry-leading manufacturer of fabric structures and greenhouses with over 30,000 products distributed through direc ...
-
Life Enrichment Coord
2 weeks ago
HRA South Windsor, United StatesAssists with the planning of the monthly activities calendar and monthly newsletter (if necessary) · Encourages residents to participate in community activities, assisting them to attend, while supporting the resident's independence · Help with ordering supplies and equipment f ...
-
Bench Assistant Deli Team Lead
2 weeks ago
Price Chopper Middletown, United StatesSalary: $17.00- $23.00 · SUMMARY · Provides fast, friendly, helpful and efficient service to all Price Chopper Customers. Responsible for providing a neat and clean deli operation in accordance with all corporate and state sanitation guidelines. Responsible for ordering product a ...
-
Lead Medical Assistant
3 weeks ago
Trinity Health Springfield, United StatesThis person is responsible for helping lead the team of Medical Assistants who are preparing patients for office visits, performing tasks including escorting patient to treatment rooms, obtaining pertinent patient information for medical records, and Medical Assistant, Medical, L ...
-
Manager, System Engineer
1 week ago
Symbotic Windsor, United StatesWho we are · With its A.I.-powered robotic technology platform, Symbotic is changing the way consumer goods move through the supply chain. Intelligent software orchestrates advanced robots in a high-density, end-to-end system - reinventing warehouse automation for increased effi ...
-
SAP GTS S4 Hana
2 weeks ago
ContractStaffingRecruiters Windsor, United StatesIf interested to learn more, please send resume to: · This is a functional consultant role, they will not be the Architect of the project · Reporting up to the Lead Architect · Does not require ABAP programming, have dedicated resource for that · Ideally looking for someone who h ...
-
3-11 nursing supervisor
2 weeks ago
Windsor Health & Rehabilitation Center LLC Windsor, United StatesJob Description · Job DescriptionDescription:We are looking for a dynamic and self directed Registered Nurse to join our team. · Must have long term care experience and or be willing to learn in a fast paced environment. · Ability to multitask while leading a nursing team is st ...
-
Production Manager
3 weeks ago
Mativ Windsor, United States· Description: · Our Produciton Manager supports Mativ's Sustainable & Adhesive Solutions. This individual will lead and manage the operations of all production areas to ensure that safety, quality, manufacturing standards and finances are achieved in accordance with Company ex ...
-
Lead Machinist
2 weeks ago
Triumph Group Windsor, United StatesResponsibilitiesTriumph Systems, Electronics & Control, located in Windsor, CT is currently seeking a Lead Machinist for 2nd shift. $3k Sign-on Bonus. Able to set-up and operate manual and CNC milling machines, CNC lathe, engine lathes, surface grinders or OD-ID grinders with min ...
-
Lead Technical Product Manager
1 week ago
IntePros Consulting Windsor, United StatesIntePros is looking for a · Lead Technical Product Manager · for our client with offices in Windsor, CT. · This is a full-time opportunity which will have flexibility for hybrid arrangements. · The Lead Product Manager will oversee the product portfolio and supervise other pr ...
-
PER-DIEM Certified CNA
8 hours ago
Talem Home Care - Hartford Enfield, United StatesBenefits/PerksFlexible Schedule · Weekly pay · Direct Deposit · Opportunity for Paid Time Off · Discount Programs · InsuranceMedical · Dental · Vision · Warm, Friendly, Pressure-Free Environment · Company Overview · Talem Home Care is committed to empowering people to take contr ...
-
Lead Product Manager
3 weeks ago
John Galt Staffing Windsor, United StatesThe Lead Product Manager will oversee the product portfolio, and supervise other product managers in their role to deliver and manage all products. In this role the Lead Product Manager (LPM) will also collaborate with engineering to create system architectures of solutions, and ...
-
Pharmacist
2 weeks ago
SCA Pharma Windsor, United StatesJob Type · Full-time · Description · SCA Pharmaceuticals is a dynamic rapidly growing company consisting of passionate individuals who believe in our mission of providing high quality medications that are critical in saving and sustaining human life. SCA Pharma is an FDA 503B out ...
New England Claims Team Lead Assistant - Windsor, United States - Sedgwick
Description
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.
Great Place to Work
Most Loved Workplace
Forbes Best-in-State Employer
New England Claims Team Lead Assistant - Workers Compensation
PRIMARY PURPOSE: To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Education & Licensing
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
Experience
Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
Skills & Knowledge
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
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
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 72K-102K. 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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't 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.