Workers' Claims Team Lead | NY Jurisdictional

Workers' Compensation Claims Team Lead – NY (Hybrid or Remote)

Provide leadership and technical direction for multiple teams of examiners and technical staff in the adjudication of NY Workers Compensation claims, ensuring quality, compliance, and client satisfaction.

• Supervise multiple teams of examiners and technical operations staff (minimum seven)
• Provide technical/jurisdictional direction on examiner reports and claim adjudication
• Identify and advise management on trends, problems, and process improvement opportunities
• Conduct quality reviews against audit and service contract requirements
• Act as second level of appeal for client and claimant issues, implementing final dispositions
• Review reserve amounts on high‑cost claims and claims above individual examiner authority
• Monitor third‑party claims, litigated claims, serious vocational rehabilitation claims, questionable claims, and sensitive claims as defined by the client
• Maintain client contact, promote a professional relationship, and provide written updates on specific claims
• Ensure direct reports are properly licensed in the jurisdictions serviced and that claims files are coded correctly with adequate documentation
• Administer personnel policies, staffing standards, and training recommendations
• Interview, hire, and establish performance development plans for colleagues
• Provide support, guidance, leadership, and motivation to promote maximum performance

• 5 years of NY Workers Compensation claims management experience or equivalent combination of education and experience
• High school diploma or GED required; bachelor’s degree preferred
• Professional certification in line of business preferred
• Strong supervisory experience preferred
• In-depth knowledge of New York jurisdictional requirements
• Licensing in NY preferred but not required

• Annual base salary range: $90,000 – $100,000
• Comprehensive benefits package including medical, dental, vision, 401(k) with match, PTO, disability and life insurance, employee assistance program, flexible spending or health savings account, and additional voluntary benefits
• Flexible work schedule and hybrid or remote work options
• Career development and promotional growth opportunities

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.