Analyze reported lower - level general liability claims for Sedgwick. Ensure ongoing adjudication of claims within company standards and industry best practices while working in a hybrid schedule.
About the role
- Claims Examiner responsible for analyzing and adjudicating workers' compensation claims. Ensures timely resolution and adherence to industry best practices for diverse clients.
Responsibilities
- To analyze workers' compensation claims on behalf of our valued clients to determine benefits due.
- Ensuring 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 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.
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.
- California workers' compensation claim handling experience required | SIP Preferred
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.
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