Claims Examiner – Workers Compensation, TX, OK, LA
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Plano • Louisiana • Oklahoma • United States
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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.
- Manages the litigation process; ensures timely and cost effective claims resolution.
- Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
- Ensures claim files are properly documented and claims coding is correct.
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.
- Jurisdiction Knowledge: TX, OK, LA.
- Licensing: TX or FL.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Opportunity to work in an agile environment.
- 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 & Tools
claims managementclaims processingnegotiationreserve calculationlitigation managementclaims documentationclaims coding
Soft Skills
analytical skillscommunicationproblem-solvingtime management
Certifications
professional certification