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.
About the role
- 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.
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