Claims Examiner – Workers Compensation, Home State License Required
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida, Montana, North Carolina, South Carolina, Tennessee • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- 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; and settles clams within designated authority level.
- Prepares necessary state fillings within statutory limits.
- Manages the litigation process; ensures timely and cost effective claims resolution.
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.
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 managementnegotiationreserve calculationclaims processinglitigation managementsettlement negotiationstatutory complianceaction plan developmentbenefit calculationclaims adjustment
Soft skills
analytical skillscommunicationproblem-solvingtime managementdecision making
Certifications
professional certification