Sedgwick

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner – Workers Compensation

Claims SpecialistClaims SpecialistFull TimeRemoteTeam 10,001+H1B SponsorCompany SiteLinkedIn

Location

California

Posted

24 days ago

Salary

$85K - $95K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Analyze complex or technically difficult workers' compensation claims to determine benefits due • Work with high exposure claims involving litigation and rehabilitation • Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements • Identify subrogation of claims and negotiate settlements • Manages claims through well-developed action plans to an appropriate and timely resolution • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner • Ensures claim files are properly documented and claims coding is correct

Job 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
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skills
  • Good interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations

Benefits

  • Medical
  • Dental
  • Vision
  • 401k and matching
  • PTO
  • Disability and life insurance
  • Employee assistance
  • Flexible spending or health savings account
  • Other additional voluntary benefits

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