Workers Compensation Claims Examiner analyzing claims for clients at Sedgwick, a global leader in risk and claims administration. Ensuring benefit determination and claims processing adhere to industry standards and client expectations.
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.
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.
California workers' compensation claims experience | 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.
Field Claims Representative handling property insurance claims under general supervision at Auto - Owners Insurance. Investigating, evaluating, and ensuring timely resolution of claims for agents and insureds.
Bodily Injury Claims Specialist managing a variety of claims processes and providing high - level customer service at Auto - Owners Insurance. Responsible for evaluating coverage, determining loss amounts, and engaging in negotiations.
Claims Associate managing medical claims processing and ensuring timely provider payments in Asheville office. Responsible for handling paper claims and ensuring accurate adjudication.
Claims Representative II managing PIP claims for auto insurance. Investigating and settling claims while ensuring compliance with state laws and documentation of decisions.
Workers Compensation Claims Adjuster managing assignment of claim files. Reports to Claims Supervisor and involved in establishing compensability and pursuing subrogation.
Analyze and resolve complex general liability claims including litigation in a hybrid working environment. Join Sedgwick, a global leader in risk and claims administration.
Freight Claims Specialist ensuring timely filing and resolution of freight claims. Collaborating within a logistics company recognized for supply chain innovation.
Property Claims Adjuster investigating, negotiating, and resolving commercial property claims. Delivering exceptional customer service while adhering to regulatory standards in a remote capacity.
Claims Specialist managing commercial claims for CNA, ensuring quality service and compliance with protocols. Interacting with customers and resolving claims efficiently while maintaining regulatory standards.