Claims Examiner processing and adjudicating healthcare claims at WebTPA. Involves claims research and verifying insurance coverage in a customer service role.
About the role
- Analyzing workers' compensation claims on behalf of valued clients at Sedgwick. Ensuring timely resolution and adherence to service expectations in a dynamic workplace.
Responsibilities
- To analyze workers' compensation claims on behalf of our valued clients.
- Determine benefits due, while ensuring ongoing adjudication of claims within service expectations.
- Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
- 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 claims knowledge | 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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