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Claims Examiner – Workers Compensation
SedgwickClaims Examiner analyzing Workers Compensation claims for clients at Sedgwick. Ensuring claims are adjudicated timely and accurately while providing exceptional customer service.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and managing Workers Compensation claims, ensuring timely resolution and adherence to industry best practices. Proficient in negotiating settlements and communicating effectively with claimants and clients.
Highest-signal resume keywords
Claims Management ExperienceWorkers Compensation AnalysisNegotiation SkillsClient CommunicationProfessional Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Claims AdjudicationClaims ProcessingInformation GatheringAction Plan DevelopmentSettlement Negotiation
Soft Skills
Professional CommunicationTimelinessProblem Solving
Certifications & Qualifications
Professional Certification
Industry Keywords
Workers CompensationClaims AnalysisClient Service RequirementsExcess Carrier Reporting
About the role
Key responsibilities & impact- Analyze Workers Compensation claims on behalf of our valued clients to determine benefits due.
- Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
- Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
- Investigating and gathering information to determine the exposure on the claim.
- Negotiating settlement of claims within designated authority.
- Communicating claim activity and processing with the claimant and the client.
- Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
Requirements
What you’ll need- High School Diploma or GED required.
- Bachelor's degree from an accredited college or university preferred.
- Professional certification as applicable to line of business preferred.
- 5 years of claims management experience or equivalent combination of education and experience required.
Benefits
Comp & perks- 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.