Analyze complex workers' compensation claims to determine benefits due and manage settlements. Join Sedgwick, a global leader in risk and claims administration, focusing on high-quality customer service.
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
Manages claims through well-developed action plans to an appropriate and timely resolution
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims
Approves and makes timely claim payments and adjustments; and settles claims within designated authority level
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost effective claims resolution
Requirements
Bachelor's degree from an accredited college or university preferred
Professional certification as applicable to line of business preferred
Five (5) years of claims management experience or equivalent combination of education and experience required
Subject matter expert of appropriate insurance principles and laws for line-of-business handled
Excellent oral and written communication, including presentation skills
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