Claims Examiner role at Sedgwick analyzing workers' compensation claims and ensuring timely adjudication. Requires 5 years of claims management experience and California workers' compensation knowledge.
About the role
- Analyze Workers Compensation claims for clients to determine benefits due while ensuring ongoing adjudication within service expectations. Collaborate to deliver innovative customer-facing solutions within an energetic culture.
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.
- Licensing: TX/FL preferred.
- Jurisdiction Knowledge: TX, OK, LA
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.
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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