claims team lead

Reserv

<div><h3 class="jobSectionHeader"><b>About Reserv</b></h3><p>
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.</p><p>
We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can&rsquo;t wait to meet you.</p><p></p><h3 class="jobSectionHeader"><b><br>
About the role</b></h3><p>
As a Claims Team Lead, Litigation at Reserv, you will be a working leader providing support to a claims manager with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing work done within the Commercial Auto Claims adjusting staff. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.</p><h3 class="jobSectionHeader"><b>
Who you are</b></h3><ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul><h3 class="jobSectionHeader"><b>
What we need</b></h3><p>
We need you to do all the things typical to the role:</p><ul><li>
Oversee a team of commercial auto adjuster direct reports</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li><li>
Serve as backup/ leader when the Manager is out of office</li><li>
Responsible for initial onboarding tasks/ access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li></ul><h3 class="jobSectionHeader"><b>
Requirements</b></h3><ul><li>
5+ years of insurance claims experience in multiple lines of business with bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li></ul><h3 class="jobSectionHeader"><b>
Benefits</b></h3><ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul><p></p><p><b><br>
Additionally, we will</b></p><ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul><p><br>
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</p></div><p></p>

Claims Team Lead Litigation

NTT DATA

<div>At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company&rsquo;s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.<br>
<br>
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.<br>
<br>
NTT DATA Services currently seeks Xcelys Medical Claims Team Lead to join our team remotely for a 3 month contract role.<br>
Start Date: ASAP<br>
100% Remote
<p><b>
Team Lead</b> -for Senior Claims Examiners on Xcelys System</p>
<p><b>Job Summary</b></p>
<p>The Xcelys Team Lead will oversee a team of claims examiners, ensuring the accurate and timely processing of medical claims using the Xcelys system. The lead acts as the subject matter expert (SME) for claims workflows, resolves complex issues, and monitors team performance to meet quality and productivity metrics.</p>
<p><b>Key Responsibilities</b></p>
<p><b>Team Management and Leadership</b></p>
<ul><li>Provide day-to-day guidance, coaching, and mentorship to claims examiners to develop their skills and improve performance.</li>
<li>Monitor team progress toward production targets, accuracy scores, and turnaround times.</li>
<li>Act as the first point of escalation for complex claim issues and provide expert assistance.</li>
<li>Conduct regular quality assurance reviews of team members' work to ensure compliance with regulatory and internal guidelines.</li>
<li>Handle performance evaluations and provide constructive feedback to team members.</li>
</ul>
<p><b>Xcelys Platform and Claims Processing</b></p>
<ul><li>Maintain subject matter expertise on claims adjudication processes within the Xcelys environment and associated subsystems.</li>
<li>Process comprehensive medical claims using the Xcelys system, resolving complex pends, coding issues, and contract exceptions.</li>
<li>Contribute to system enhancements, user acceptance testing (UAT), and workflow optimizations related to the Xcelys platform.</li>
<li>Report on team metrics, identify trends, and recommend corrective actions to improve efficiency.</li>
</ul>
<p><b>Collaboration and Reporting</b></p>
<ul><li>Liaise with cross-functional teams, such as provider relations, legal, and IT, to address claims system or operational improvements.</li>
<li>Prepare and deliver production, pending, and quality reports to management.</li>
<li>Support internal initiatives related to claims system improvements and operational changes.</li>
</ul>
<p><b>Required Qualifications and Skills</b></p>
<ul><li>4+ YEARS XCELYS SYSTEM EXPERIENCE</li>
<li>MINIMUM 3 YEARS TEAM LEAD EXPERIENCE</li>
<li>MINIMUM 7 YEARS CLAIMS EXPERIENCE</li>
<li>MUST WORK PST WEST COAST HOURS (8AM-5PM)</li>
</ul>About NTT DATA Services:<br>
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.<br>
<br>
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.<br>
<br>
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is <b>($23 - $24/hourly )</b>. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.<br>
<br>
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&amp;D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.</div>

Xcelys Medical Claims - Team Lead

MAG Mutual Insurance Company

<div>The Team Lead will oversee a group of Claim Analysts responsible for managing professional liability claims and lawsuits. The Team Lead will focus on ensuring consistency in macro-level case development, ensuring that optimal defense strategies are consistently implemented throughout the life of each file, and on the strategic management of defense counsel. By leveraging advanced data analytics and predictive modeling, the Team Lead will develop and implement data-informed, innovative, and proactive approaches to managing claims, and monitor team performance to drive superior outcomes for our PolicyOwners.<br>
<br>
In this leadership role, the Team Lead will work closely with the Head of External Counsel Claims Management, Head of Internal Counsel Claims Management, and Chief Claims Officer, providing key insights into claims performance, emerging trends, and strategic opportunities. Additionally, the Team Lead will contribute to company-wide strategic initiatives aimed at redefining the claims management process within the professional liability insurance industry.<div>
SPECIFIC DUTIES:</div><div></div><div>
Strategic Leadership &amp; Development &amp; Process Improvement</div><ul><li>
Lead a team of Claim Analysts in the implementation of optimal strategies and tactics at every stage of the claims process to drive superior claim outcomes.</li><li>
Contribute to the strategic development of macro claims strategies, relying on data-driven insights, ensuring consistent application across all claims.</li><li>
Foster a culture of innovation, continuous learning and development, and transparent communication with team members, PolicyOwners and other key stakeholders.</li><li>
Work collaboratively across departments to ensure optimal support for PolicyOwners.</li><li>
Work closely with the Chief Claims Officer and other senior leaders to align team performance with company-wide strategic goals.</li><li>
Partner with cross-functional teams to evaluate metrics, develop and refine processes, and implement initiatives that improve overall claims resolution and PolicyOwner experience.</li></ul><div></div><div>
Claims Performance &amp; Data Analytics</div><ul><li>
Analyze macro-level claims data and trends using structured data and AI-driven insights to enhance strategic decision-making.</li><li>
Utilize data visualization tools (e.g., Qlik Sense) to present claims performance to key stakeholders and drive process improvements.</li><li>
Monitor key performance indicators and provide actionable insights to the Chief Claims Officer and other senior leaders through detailed reports and dashboards to evaluate the effectiveness of claims strategies.</li><li>
Utilize data analytics and predictive modeling tools to identify high-exposure claims and proactively adjust strategies.</li></ul><div></div><div>
Defense Counsel Management</div><ul><li>
Provide high-level oversight of defense costs, maintaining effective defense strategies while ensuring alignment with financial targets.</li><li>
Provide oversight to ensure DCC reserves are accurately set based on historical payment data and case attributes.</li><li>
Take responsibility for ensuring defense counsel performance meets established benchmarks team wide.</li></ul><div></div><div>
QUALIFICATIONS, EXPERIENCE REQUIRED:</div><ul><li>
Bachelor&rsquo;s degree required</li><li>
7-10 years of experience in claims management, insurance adjusting, or JD with medical malpractice litigation experience.</li><li>
Demonstrated leadership or supervisory experience in a claims, legal, or risk management setting, with the ability to mentor and develop high-performing teams and the ability to collaborate cross-functionally and work closely with executive leadership.</li><li>
Ability to analyze complex data sets to identify trends, risks, and opportunities in claims performance.</li><li>
Proficiency in legal software (e.g., LSS), Excel, and data visualization tools (Qlik Sense or similar).</li><li>
Strong understanding of reserve management, defense cost containment, and financial oversight of claims.</li><li>
Strong strategic acumen and critical thinking skills, with the ability to recognize potential liability issues and adapt strategies accordingly.</li><li>
Ability to operate in a fast-paced, dynamic environment, managing multiple priorities effectively, while adapting to change.</li><li>
Excellent written and verbal communication skills, capable of conveying complex information to diverse stakeholders, including executives and Board members.</li><li>
Commitment to continuous learning and staying current on state, federal, and industry trends.</li></ul><div></div><div>
JOB REPORTS TO:</div><ul><li>
Chief Claims Officer</li></ul><div></div><div>
Location:</div><div></div>
Atlanta Office</div>

SIR/HPL Claims Team Lead

<div><p><b>About Reserv</b></p><p>
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.</p><p>
We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can&rsquo;t wait to meet you.</p><p></p><p><b><br>
About the role</b></p><ul><li>
As a Team Lead at Reserv, you will be a working leader providing support to a Claims manager with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing work done within the Commercial Auto Claims adjusting staff. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.</li></ul><p><b>
Who you are</b></p><ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul><p><b>
What we need</b></p><p>
We need you to do all the things typical to the role:</p><ul><li>
Flexibility - you will need to be able to switch from claims handling to coaching and feedback</li><li>
Agility- you must have an agile mindset and the ability to pivot from focus to focus in a moment&rsquo;s notice</li><li>
Be consistently dependable in achieving or exceeding goals and overcoming obstacles</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li></ul><p><b>
Job Duties:</b></p><ul><li>
Serve as backup/leader when the Manager is out of office</li><li>
Responsible for having direct reports</li><li>
Responsible for initial onboarding tasks / access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li><li>
Customer Obsession Champions - Active advocates who help leadership cultivate a customer-centric mindset</li></ul><p><b>
Requirements</b></p><ul><li>
5+ years of insurance claims experience in multiple lines of business, preference for an auto with some bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</li></ul><p></p><p><b><br>
Benefits</b></p><ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul><p></p><p><b><br>
Additionally, we will</b></p><ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul><p><br>
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</p></div><p></p>

Claims Team Lead Auto Property Damage

Sedgwick

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Claims Team Lead, Professional Liability | Missouri
<p></p><div><p><b>PRIMARY PURPOSE </b><b>: </b>To supervise the operation of multiple teams of examiners and technical staff for liability claims 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.
</p><p><b>ESSENTIAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Supervises multiple teams of PL Specialists and/or multiple claims colleagues for wide span of control; and delegates duties to others within the unit as needed.
</li><li>Identifies and advises management of trends, problems, and issues; makes recommendations on course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for assigned office(s).
</li><li>Provides technical/jurisdictional direction to PL Specialists on claims issues and resolution.
</li><li>Compiles, reviews and analyzes management reports and takes appropriate action.
</li><li>Performs quality review on claims in compliance with audit requirements, service contract requirements and quality standards.
</li><li>Reviews reserve amounts on high cost claims and claims over the authority of individual PL Specialists.
</li><li>Maintains periodic review of claims that are litigated, sensitive, or questionable as determined by the client.
</li><li>Maintains contact with client on claims and promotes professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes on specific claims as requested by client.
</li><li>Maintains frequent diaries on complex or high exposure claims.
</li><li>Ensures that direct reports are properly licensed in the jurisdiction serviced.
</li><li>Ensures claim files are coded correctly and adequate documentation is made by PL Specialists.
</li></ul><p><b>ADDITIONAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Performs other duties as assigned.
</li><li>Supports the organization quality program(s).
</li></ul><p><b>SUPERVISORY RESPONSIBILITIES
</b></p><ul><li>Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
</li><li>Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
</li><li>Provides support, guidance, leadership and motivation to promote maximum performance.
</li></ul><p><b>QUALIFICATIONS
</b></p><p><b>Education &amp; Licensing
</b><br>
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.
</p><p><b>Experience
</b><br>
Eight (8) years of claims management experience related to professional liability claims or equivalent combination of education and experience required to include two (2) years of claims supervisor experience.
</p><p><b>Skills &amp; Knowledge
</b></p><ul><li>Thorough knowledge of claims management processes and procedures for multiple product lines
</li><li>Excellent oral and written communication, including presentation skills
</li><li>PC literate, including Microsoft Office products
</li><li>Leadership/management/motivational skills
</li><li>Analytical and interpretive skills
</li><li>Strong organizational skills
</li><li>Excellent interpersonal skills
</li><li>Excellent negotiation skills
</li><li>Ability to work in a team environment
</li><li>Ability to meet or exceed Performance Competencies
</li></ul><p><b>WORK ENVIRONMENT
</b><br>
When applicable and appropriate, consideration will be given to reasonable accommodations.
</p><p><b>Mental </b><b>: </b>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
</p><p><b>Physical </b><b>: </b>Computer keyboarding, travel as required
</p><p><b>Auditory/Visual </b><b>: </b>Hearing, vision and talking
</p><p></p><p>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.
</p></div><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>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.</b></h2></div>

Claims Team Lead, Professional Liability | Missouri

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Workers Compensation Claims Team Lead | Roseville, CA
<p>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&rsquo;s best brands?
</p><p></p><ul><li><p>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</p></li><li><p>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</p></li><li><p>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</p></li><li><p>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</p></li><li><p>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</p></li><li><p>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</p></li><li><p>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</p></li></ul><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>OFFICE LOCATIONS
</b></p><p>Roseville, CA - Hybrid (3 days in office, 2 days remote)
</p><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>Oversees multiple teams of examiners and technical staff handling workers compensation claims for clients. 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.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li><p>Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
</p></li><li><p>Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
</p></li><li><p>Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
</p></li><li><p>Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
</p></li><li><p>Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
</p></li><li><p>Maintains professional client relationships, offering recommendations and written summaries as needed.
</p></li><li><p>Ensures accurate claim coding and documentation by examiners.
</p></li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education &amp; Licensing: 6 years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
</p><ul><li><p>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</p></li><li><p>Professional certification as applicable to line of business preferred.
</p></li></ul><p></p><p><b>Licensing / Jurisdiction Knowledge: </b>California workers compensation claim handling experience | SIP Certified
</p><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li><p>Flexible work schedule.
</p></li><li><p>Referral incentive program.
</p></li><li><p>Career development and promotional growth opportunities.
</p></li><li><p>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</p></li></ul><p></p><p>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 $105,000-$110,000/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.
</p><p></p><p>#LI-GC1 #LI-Hybrid #claims #claimsteamlead
</p><p></p><p>Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles&rsquo; Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>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.</b></h2></div>

Workers Compensation Claims Team Lead | Roseville, CA

Erie Insurance Group

<div><div><div><div><div><div><b>Division or Field Office:<br>
</b></div></div><div><div>Claims I Division</div></div><br>
</div><br>
<div><div><b>Department of Position:</b></div> <div>Zone Operations Dept</div></div><br>
<div>
<div><div><b>Work from:</b></div>
</div>
<div> Brentwood Branch Office</div>
</div><br>
<div><div><b>Salary Range:</b></div>
<div>
<div>$88,693.00 - $141,678.00 *</div>
<div><i>
salary range is for this level and may vary based on actual level of role hired for</i></div>
</div>
</div><br>
</div></div><ul><li><i>This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment.</i></li></ul><br>
<div></div>
<div>
At Erie Insurance, you&rsquo;re not just part of a Fortune 500 company; you&rsquo;re also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia.<br>
<br>
<b>Benefits That Go Beyond The Basics</b></div>
<div>
We strive to be Above all in Service&reg; to our customers&mdash;and to our employees. That&rsquo;s why Erie Insurance offers you an exceptional benefits package, including:</div>
<ul>
<li><b>Premier health, prescription, dental, and vision benefits for you and your dependents.</b> Coverage begins your first day of work.</li>
<li><b>Low contributions to medical and prescription premiums.</b> We currently pay up to 97% of employees&rsquo; monthly premium costs.</li>
<li><b>Pension. </b>We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service.</li>
<li><b>401(k) with up to 4% contribution match.</b> The 401(k) is offered in addition to the pension.</li>
<li><b>Paid time off.</b> Paid vacation, personal days, sick days, bereavement days and parental leave.</li>
<li><b>Career development. </b>Including a tuition reimbursement program for higher education and industry designations.</li><br>
</ul>
<div>Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year.</div><div></div><div><div><div><div><b><br>
Position Summary</b></div>
</div><div><div><i>
Supervises, trains, and monitors the activities of assigned claims adjusters and other claims personnel. Assists the Claims Manager or VP, Field Claims in the overseeing and handling of claims.</i></div>
<div><b>
Experience handling personal and commercial AUTO LIABILITY CLAIMS is preferred.</b></div>
<div><i>
This is an in-office position based at ERIE's Brentwood, TN Branch Office that will lead a Zone Operations Team. Hours are Monday - Friday 8:00 am - 4:30 pm. Schedule and work location subject to change based on business and service level needs.</i></div></div></div><div><div><div><b>
Duties and Responsibilities</b></div>
</div><div><ul><li>Manages overall operations of designated area of authority. Interviews, hires, trains, and directs personnel. Prepares and conducts performance assessments, coordinates discipline and oversees Employee development as required.</li>
<li>Reviews claims on a regular basis in accordance with company policy. When appropriate, set up files of adjusters, checking for coverage, adequate reserves and acts as a resource for answering claims questions. Provides additional services as required. Takes action as necessary.</li>
<li>Reviews claim correspondence and provides counsel on further action.</li>
<li>Resolves coverage or unusual questions within designated authority. Conducts related research as necessary.</li>
<li>Maintains and applies a working knowledge of adjuster&rsquo;s files. Maintains knowledge of statutory laws.</li>
<li>Makes recommendations to and participates with Claims Manager in developing and evaluating claims procedures.</li>
<li>Handles claim complaints and inquiries.</li>
<li>Assists Claim Manager and may act on his/her behalf as necessary.</li>
<li>Where applicable receives and directs processing of legal papers served upon ERIE involving claims action. Also directs activities of outside legal counsel as required.</li>
</ul></div></div><div><div><div><b>Duties and Responsibilities (cont'd if applicable)</b></div>
</div><div><ul><li>Where applicable, assists in preparation for trial procedures where applicable. Attends pre-trial functions and trials as necessary.</li>
<li>Where applicable, directs salvage disposal, reviews reports, payments and buyers. Negotiates with salvage action and salvage yards on behalf of the company.</li></ul><br>
<div><br>
<i>The first five duties listed are functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.</i></div><br>
<div><br>
<i>This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job -related instruction and to perform any other duties as required by their supervisor or as becomes evident.</i></div>
</div></div><div><div><div><b>
Capabilities</b></div>
</div><ul><li>Collaborates (Leader)
</li><li>Cultivates Innovation (Leader)
</li><li>Customer Focus (Leader)
</li><li>Decision Quality (Leader)
</li><li>Develops Talent (Leader)
</li><li>Drives vision and purpose (Leader)
</li><li>Ensures Accountability (Leader)
</li><li>Instills Trust (Leader)
</li><li>Nimble Learning (Leader)
</li><li>Persuades (Leader)
</li><li>Plans and Aligns (Leader)
</li><li>Values Diversity (Leader)
</li><li>Self-development (Leader)
</li><li>Optimizes Work Processes (Leader)
</li></ul></div><div><div><div><b>Qualifications</b></div>
</div><div><div><b>
Minimum Educational</b></div>
<ul>
<li>High school diploma or GED required.</li>
<li>Bachelor's degree preferred.</li></ul><br>
<div><br>
<b>Additional Experience</b></div>
<ul>
<li>Six years of discipline specific claims adjusting experience, or equivalent estimating experience in a Claims leadership role required.</li>
<li>In depth knowledge of estimating software preferred.</li>
<li>Where applicable, the position requires the incumbent to serve on the Catastrophe Team, which may include travel on short notice to other locations for periods in excess of two consecutive weeks.</li></ul><br>
<div><br>
<b>Designations and/or Licenses</b></div>
<ul>
<li>Completion of Associate in Claims (AIC) designation preferred.</li>
<li>Obtain appropriate licenses as required by state within 45 days of employment in the role for external applicants and 90 days of employment in the role for internal applicants.</li>
<li>Valid driver's license where required.</li>
</ul></div></div><div><div><div><b>Physical Requirements</b></div>
</div><ul><li>Use of Personal Protective Equipment (PPE) is required for this role.
</li><li>Ability to move over 50 lbs using lifting aide equipment; Rarely
</li><li>Climbing/accessing heights; Rarely
</li><li>Driving; Occasional (&lt;20%)
</li><li>Lifting/Moving 0-20 lbs; Rarely
</li><li>Lifting/Moving 20-50 lbs; Rarely
</li><li>Manual Keying/Data Entry/inputting information/computer use; Often (20-50%)
</li><li>Pushing/Pulling/moving objects, equipment with wheels; Rarely</li></ul></div></div><br>
<p><br>
<b>Nearest Major Market: </b>Nashville</p></div>

Claims Supervisor

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