Claims Manager I Workers Compensation

Sedgwick; Garden City (ID); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading risk and claims administration partner in Garden City seeks a Claims Manager I for Workers Compensation to supervise multiple teams and manage claim activities. The ideal candidate will have six years of claims experience, including two years in a supervisory role, and strong leadership and communication skills. This position supports professional growth and provides a meaningful work environment.

Benefits

Work-life balance

Caring culture

Qualifications

• Six years of claims experience or equivalent combination of education and experience required.
• Two years of claims supervisory experience is required.

Responsibilities

• Supervises multiple teams of examiners for workers compensation claims.
• Monitors colleagues' workloads and provides training.
• Addresses client and claimant issues in claims.
• Maintains professional client relationships.

Skills

Claims management processes

Excellent oral and written communication

Leadership/management skills

Analytical skills

Organizational skills

Interpersonal skills

Negotiation skills

Teamwork ability

Education

Bachelor's degree from an accredited college

Professional certifications

Tools

Microsoft Office

Job description

Overview

By joining Sedgwick, you'll 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.

Position

Claims Manager I 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. Seeking California, Central, and Eastern experience.

Responsibilities

• 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.

Additional Functions and Responsibilities

• Performs other duties as assigned.


• Supports the organization's quality program(s).

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

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

• 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

Work Environment

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.