About this opportunity
Sedgwick lists this Absence Management Team Lead - Coding Team opportunity in dubuque, Iowa. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Absence Management Team Lead - Coding TeamPRIMARY PURPOSE: To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, 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 within the teams including frequent diaries on complex or high exposure claims.ESSENTIAL FUNCTIONS AND RESPONSIBILITIESSupervises multiple teams of examiners and/or several 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 RESPONSIBILITIESPerforms other duties as assigned.Supports the organization's quality program(s).SUPERVISORY RESPONSIBILITIESAdministers 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.QUALIFICATIONSEducation & 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. Two (2) years of claims supervisory experience preferred.Skills & KnowledgeThorough knowledge of claims management procedures and processes for disabilityExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsLeadership/management/motivational skillsAnalytical and interpretive skillsStrong organizational skillsExcellent interpersonal skillsExcellent negotiation skillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK 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 deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingSedgwick 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.
Worksite address
dubuque, IA, 52002, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.