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Claims Examiner – Workers Compensation, Licensing Required
SedgwickClaims Examiner handling complex workers' compensation claims at Sedgwick, a global risk and claims administration firm. Collaborating to provide innovative solutions across various industries.
About the role
Key responsibilities & impact- Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim;
- 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;
- manages the litigation process; ensures timely and cost effective claims resolution;
- communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Requirements
What you’ll need- 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: OR Licensing: OR.
Benefits
Comp & perks- 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.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims managementclaims processingsettlement negotiationreserve calculationbenefit calculationlitigation managementclaims resolution
Soft Skills
communicationrelationship management
Certifications
professional certification