Claims Examiner analyzing complex workers' compensation claims at Sedgwick. Working with litigation and rehabilitation while ensuring compliance with service expectations and industry best practices.
Responsibilities
To analyze complex or technically difficult workers' compensation claims to determine benefits due.
To work with high exposure claims involving litigation and rehabilitation.
To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements.
To identify subrogation of claims and negotiate settlements.
Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by 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
5 years of claims management experience or equivalent combination of education and experience required.
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.
Public Entity experience preferred.
Licensing / Jurisdiction Knowledge: TX
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.
Job title
Claims Examiner – Workers Compensation, Public Entity Experience Preferred
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