Claims Team Lead - Workers Compensation; HYBRID- Roseville, CA

Claims Team Lead – Workers Compensation (Hybrid – Roseville, CA)

Dedicated CA self‑insured client. CA self‑insured certificate required and candidate must reside and work in CA.

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.

• Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
• Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high‑cost or complex claims.
• Acts as a second‑level appeal authority for client and claimant issues, implementing final decisions.
• Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
• Monitors third‑party and sensitive claims, including litigated and vocational rehabilitation cases.
• Maintains professional client relationships, offering recommendations and written summaries as needed.
• Ensures accurate claim coding and documentation by examiners.

• Education & Licensing: 6 years of claims experience or equivalent combination of education and experience required, including two (2) years claims supervisor experience. High School Diploma or GED required;
  Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• Licensing / Jurisdiction Knowledge:
  California workers compensation license and claims handling experience required.

• Flexible work schedule;
  Hybrid schedule (3 days in office).
• Referral incentive program.
• Career development and promotional growth opportunities.
• Comprehensive benefits including medical, dental, vision, 401(k) on day one, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits.

• 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.
• Auditory/Visual:
  Hearing, vision and talking.

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

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' 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.