Appeals Analyst – GP
NJM Insurance Group
Workers' Compensation Claims Adjuster
Sedgwick
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $80,000 - $90,000 per year
Job Level
JuniorMid-Level
About the role
- To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Analyze and process claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. Negotiate settlement of claims within designated authority. Communicate claim activity and processing with the claimant and the client. Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.
Requirements
- 2-4 years of claims management experience or equivalent combination of education and experience required. High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Jurisdiction Knowledge: MD, NJ & PA Licensing: preferred, not required. Work environment requirements for entry-level opportunities include: Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
