Claims Adjuster - Workers Comp
PRIMARY PURPOSE OF THE ROLE:
We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
About the Role
Join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands. Apply your Workers' Comp Claims Adjuster knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Responsibilities
- Analyzes Workers' Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
- 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.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Safeguards claim files are properly documented and claims coding is correct.
- Maintains professional client relationships.
Qualifications
- 4 years of claims management experience or equivalent combination of education and experience required.
- A high school diploma or GED required.
- A bachelor's degree from an accredited college or university preferred.
- A professional certification as applicable to line of business preferred.
Benefits
Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
Enjoy flexibility and autonomy in your daily work, your location, and your career path.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment.
Career development and promotional growth opportunities.
A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.