Education: Bachelor's degree
Experience: 1+ year
We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
PRIMARY PURPOSE : To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements
- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
- Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Performs other duties as assigned. - Supports the organization's quality program(s). - Travels as required.
Bachelor's degree from an accredited college or university preferred; Home state license required
- Flexible work schedule. - Referral incentive program. - Career development and promotional growth opportunities. - A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
WORK ENVIRONMENT REQUIREMENTS INCLUDE 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 - Auditory/Visual: Hearing, vision and talking
#claimsexaminer #claims #LI-REMOTE
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.
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