Description
A career at Sedgwick means experiencing a culture of caring. You'll have flexibility and time for the things that matter to you, support for your mental, physical, financial, and professional needs, and opportunities to grow your career.
As a Claims Examiner - Workers Comp, you'll analyze complex workers' compensation claims to determine benefits due, work with high-exposure claims involving litigation and rehabilitation, and ensure ongoing adjudication of claims within service expectations.
Responsibilities:
- Analyze and process complex workers' compensation claims
- Negotiate settlement of claims within designated authority
- Calculate and assign reserves to claims
- Manage litigation process and ensure timely claims resolution
- Coordinate vendor referrals for additional investigation and/or litigation management
- Use cost containment techniques to reduce overall cost of claims
- Manage claim recoveries, including subrogation and Social Security and Medicare offsets
- Communicate claim activity and processing with claimants and clients
- Ensure claim files are properly documented and coded correctly
Requirements:
- Bachelor's degree from an accredited college or university preferred
- 5 years of claims management experience or equivalent combination of education and experience required
- Subject matter expertise in insurance principles and laws, recoveries offsets and deductions, claim and disability duration, and cost containment principles
- Excellent oral and written communication, analytical, and interpretive skills
- Strong organizational and negotiation skills
- Ability to work in a team environment and meet or exceed service expectations
Benefits:
- Comprehensive benefits package, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, and employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
Salary: $80-85K per year