• WFA Team Lead

    Sedgwick (Orlando, FL)


    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

    WFA Team Lead

    **PRIMARY PURPOSE** : To assist with claims examiner workload management; to provide guidance, training and mentoring to claims examiners; and to coordinate support activities and lead department projects within the unit.

    ESSENTIAL FUNCTIONS and RESPONSIBILITIES

    + Maintains claim caseload; analyzes mid and higher-level disability claims to determine benefits; ensures ongoing adjudication of claims; and provides appropriate risk management for assigned claims.

    + Assigns new cases in the absence of team lead.

    + Manages data integrity reports; distributes reports to appropriate examiners and ensures claim updates have been made; analyzes reports for trends; and makes recommendations to management for error reduction.

    + Advises team lead of urgent issues and of problems/issues for review.

    + Assists in developing action plans to address adverse trends.

    + Assists in developing account contact information and maintaining account records.

    ADDITIONAL FUNCTIONS and RESPONSIBILITIES

    + Performs other duties as assigned.

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

    QUALIFICATIONS

    Education & Licensing

     

    Bachelor's degree from an accredited college or university preferred.

    Experience

    Four (4) years of case management experience or equivalent combination of education and experience required. Supervisory experience preferred.

    Skills & Knowledge

    + Thorough knowledge of claims management procedures and processing

    + Knowledge of ERISA regulations; required offsets and deductions; disability and medical management practices; and Social Security application procedures may be required for some units.

    + 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

    + Ability to work in a team environment

    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

     

    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.

     

    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.

     

    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. For more, see** **sedgwick.com