Claims Associate at Qover engaging with customers for claims processing. Assisting in claim assessments while ensuring clear communication and providing support in various languages.
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Hybrid Workers Compensation Claims Examiner, CA Jurisdiction Knowledge Required
Posted 3 months ago
About the role
- Adjudicate complex workers' compensation claims in a caring culture at Sedgwick. Join a growing company known for its innovative customer-facing solutions and career development opportunities.
Responsibilities
- To analyze complex or technically difficult workers' compensation claims to determine benefits due.
- Manage claims through well-developed action plans to an appropriate and timely resolution.
- Negotiate settlement of claims within designated authority.
- Prepare necessary state fillings within statutory limits.
- Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Requirements
- Five (5) years of claims management experience or equivalent combination of education and experience required.
- Bachelor's degree from an accredited college or university preferred.
- Professional certification as applicable to line of business preferred.
- California jurisdiction knowledge; SIP required or must be obtained within one (1) year of employment.
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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