Claims Adjuster - Workers Compensation

@ Sedgwick

About Claims Adjuster - Workers Compensation

Sedgwick is a global leader in risk management, health, welfare, and integrated insurance solutions. With a presence in 65 countries and 27,000 colleagues worldwide, Sedgwick delivers excellence to its clients and partners.

The Role

As a Claims Adjuster - Workers Compensation, you will adjudicate complex customer claims within an energetic culture. You will apply your expertise to determine benefits due, manage action plans, facilitate return-to-work efforts, negotiate settlements, and ensure claims files are properly documented following industry best practices.

Essential Functions & Responsibilities

• Manage workers compensation claims including long term indemnity claims.
• Develop and manage claims action plans to resolution.
• Approve and process claims in accordance with company standards.
• Negotiate settlements and manage subrogation of claims.
• Maintain effective communication with claimants and clients.
• Ensure documentation and correct coding of claim files.
• Process complex lifetime medical or defined period medical claims.
• Travel as required and support quality programs.

Qualifications

A bachelor’s degree is preferred and 3-4 years of workers compensation claims management experience or equivalent combination of education and experience is required.

Benefits

• Flexible work schedule
• Referral incentive program
• Career development and growth opportunities
• Diverse and comprehensive benefits including medical, dental, vision, and 401K starting day one

Key Skills/Competency

• Workers Compensation
• Claims Management
• Adjudication
• Subrogation
• Negotiation
• Documentation
• Risk Analysis
• Return-to-Work
• Customer Communication
• Action Planning