Claims Adjuster – Workers Compensation
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Plano • California • Texas • United States
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About the role
- Analyzes mid- and higher-level workers compensation claims to determine benefits due.
- Ensures ongoing adjudication of claims within company standards and industry best practices.
- Identifies subrogation of claims and negotiates settlements.
- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims.
- 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.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- Maintains professional client relationships.
Requirements
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certifications as applicable to line of business preferred.
- Four (4) 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 managementworkers compensation claims analysisnegotiationclaims adjudicationclaims codingaction plan developmentlong term indemnity claims managementsubrogation identificationbenefits determination
Soft skills
communicationclient relationship managementorganizational skills
Certifications
professional certifications