Claims Examiner – Workers Compensation
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: Remote • Alabama, Florida, Kentucky, Mississippi, Tennessee, Virginia • 🇺🇸 United States
Visit company websiteSalary
💰 $70,000 - $80,000 per year
Job Level
Mid-LevelSenior
About the role
- To analyze complex or technically difficult workers' compensation claims to determine benefits due.
- To work with high exposure claims involving litigation and rehabilitation.
- To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements.
- To identify subrogation of claims and negotiate settlements.
- Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
- Manages claims through well-developed action plans to an appropriate and timely resolution.
- Negotiates settlement of claims within designated authority.
- Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments.
Requirements
- Bachelor's degree from an accredited college or university preferred.
- Professional certification as applicable to line of business preferred.
- Five (5) years of claims management experience or equivalent combination of education and experience required in some of the following states: TN/AR/MS/KY/AL/GA/FL
Benefits
- 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.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims managementnegotiationsubrogationbenefits calculationreserve managementaction planninglitigation managementrehabilitation managementclaims analysisclaims processing
Soft skills
analytical skillscommunicationproblem-solvingattention to detailtime managementdecision makinginterpersonal skillsorganizational skillsnegotiation skillscustomer service
Certifications
professional certification in claims management