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Claims Team Leader - Workers' Compensation
at Sedgwick CMS in Pennsylvania
Claims Team Leader
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To be responsible for the technical and operational functions of claim unit(s) including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to be responsible for staffing and training needs, as well as staff development, career and succession planning; and to assist the Operations Manager with budget preparation and profit and loss management for the office. To lead the operation of teams which administer claims for clients; to provide technical and jurisdictional direction, overall management and training of claims staff in applicable jurisdictions.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
1. Provides technical and jurisdictional direction and training to claims examiners on claims adjudication.
2. Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
3. Monitors claims examiner workloads ensuring compliance with service standards.
4. Maintains contact with the client on claims and promotes a professional client relationship; provides recommendations to client as suggested by the claim status; and provides written reports of specific claims as requested by client.
5. Monitors management reports relating to location or office performance.
6. Maintains a quality assurance program to support the total performance management initiative and the consistent delivery of quality claims service.
7. Travels as required.
SUPERVISORY RESPONSIBILITIES
1. Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
2. Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
3. Provides support, guidance, leadership and motivation to promote maximum performance.
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required.
Experience
Seven(7) years of claims management experience required. Supervisory experience preferred.
Skills & Knowledge
-Good technical knowledge of claims management.
-Excellent oral and written communication, including presentation skills
-PC literate, including Microsoft Office products
-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
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
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
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 CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/19516775
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To be responsible for the technical and operational functions of claim unit(s) including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to be responsible for staffing and training needs, as well as staff development, career and succession planning; and to assist the Operations Manager with budget preparation and profit and loss management for the office. To lead the operation of teams which administer claims for clients; to provide technical and jurisdictional direction, overall management and training of claims staff in applicable jurisdictions.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
1. Provides technical and jurisdictional direction and training to claims examiners on claims adjudication.
2. Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
3. Monitors claims examiner workloads ensuring compliance with service standards.
4. Maintains contact with the client on claims and promotes a professional client relationship; provides recommendations to client as suggested by the claim status; and provides written reports of specific claims as requested by client.
5. Monitors management reports relating to location or office performance.
6. Maintains a quality assurance program to support the total performance management initiative and the consistent delivery of quality claims service.
7. Travels as required.
SUPERVISORY RESPONSIBILITIES
1. Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
2. Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
3. Provides support, guidance, leadership and motivation to promote maximum performance.
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required.
Experience
Seven(7) years of claims management experience required. Supervisory experience preferred.
Skills & Knowledge
-Good technical knowledge of claims management.
-Excellent oral and written communication, including presentation skills
-PC literate, including Microsoft Office products
-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
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
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
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 CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://sedgwickcms.contacthr.com/19516775
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Published on Apr 28, 2011
Viewed: 473 times
Viewed: 473 times
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