Workforce Absence Team Lead

Thorough knowledge of claims management procedures and processes for disability

PC literate, including Microsoft Office products

Supervises 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.

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.