Claims Team Leader

Claims Team Lead HealthCare Insurance 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.  

Great Place to Work®  

Most Loved Workplace®   

Forbes Best-in-State Employer  

Key roles 

 This role focuses specifically on leading the Claims function, ensuring endtoend claims process efficiency, quality, and regulatory compliance. The Claims Team Leader will work closely with the Operations Manager to review claims workflows, identify areas for improvement, and drive best practice across the team. 

Specific responsibilities (including but not limited to) 

• To provide strong and visible leadership to their Team members through clear and engaging communication and working collaboratively with the Operations Manager to consistently achieve SLAs and Targets. 

• Review claims processes endtoend to uncover inefficiencies and drive targeted process enhancements. 

• Provide clear feedback on where claims processes can be streamlined, automated, or made more efficient. 

• Oversee the use of manual work trackers to consistently track workflow progress, backlogs, and claims processing activity. 

• Conduct regular performance conversations related to claims accuracy, productivity, and SLA delivery. 

• Support capacity planning by assessing workload volumes, capability, and future pipeline trends. 

• Act as a technical escalation point for claims queries, exceptions, and complex cases. 

• Ensure claims handling is compliant with CPC and all related regulatory requirements. 

• Responsible for team delivery of a professional and motivated customer services. 

• To develop the Performance of the team in collaboration with the Operations Manager and fellow Team Leaders. 

• Point of technical and process referral for the Team members. 

• Performance management including completion of monthly incentives for direct reports, working with the Operations Manager to set and monitor appropriate team and individual targets. 

• Active involvement in weekly team meetings to review and develop team performance. 

• To support the Operations Manager in planning resource / scheduling. 

• To liaise with the QA Unit to monitor and resolve complaints in accordance with CPC. 

• Work with Operations Manager to develop Management Information for monitoring of team performance. 

Qualifications/skills 

• APA or CIP Qualification in Insurance in Ireland - MUST HAVE 

• Experience as a Claims Team Leader is essential 

• Strong understanding of claims workflows, decision points, and assessment processes. 

• Experience using manual work trackers and workflow monitoring tools 

• Ability to identify process inefficiencies and propose practical solutions 

• Experience having structured performance conversations and coaching team members 

• Understanding of capacity planning and workload allocation within a claims environment 

• Health Insurance / PMI claims experience highly desirable 

• General insurance and /or operational management within business process outsourcing background desirable 

• A degree in business or related discipline 

• Client or Project Management experience desirable 

• Experience with training and managing quality in complex multi-client environment 

• Excellent written and verbal communication skills 

• Experience managing Work Force Planning / Optimisation (desirable not essential) 

• Excellent motivational and organisational skills 

• IT literate including all MS platforms 

Experience 

• Previous experience as a Claims Team Leader or senior claims role 

• Demonstrated experience leading claims staff, coaching, and supporting technical decisionmaking 

• Experience analysing claims data, identifying patterns, and responding to operational issues 

• Familiarity with claims quality standards and complaint resolution processes 

• Proficient in Microsoft Word / Excel / PowerPoint 

• Demonstrated strong people management skills 

Benefits of working for Sedgwick in Ireland 

• Bike to Work Scheme 

• Tax Saver Travel Scheme 

• Discounted onsite Gym Membership (Dublin 4) 

• Discounted onsite Montessori (Dublin 4) 

• EAP – Employee Assistance Programme  

• Health Insurance Scheme 

• Life Cover 

• PHI – Permanent Health Insurance 

• Exams & Professional Membership Fees 

• Professional and personal development opportunities 

Sedgwick Ireland is regulated by the Central Bank of Ireland (CBI). This role is subject to the Minimum Competency Code (MCC) as set out by the CBI. This code sets out the minimum professional standard for any person providing certain financial services, in particular when dealing with consumers. This role is classified as a Controlled function ( CF5 CF6 & CF7 ) and is subject to Fitness and Probity Standards, including the requirements outlined in the Individual Accountability Framework Act 2023. Successful candidates will receive training in relation to all regulatory requirements applicable to them.