Claims Examiner - Workers Compensation

Claims SpecialistClaims SpecialistFull TimeRemoteSeniorTeam 10,001+H1B SponsorCompany SiteLinkedIn

Location

Tennessee

Posted

5 days ago

Salary

0

Seniority

Senior

Bachelor Degree4 yrs expEnglish

Job Description

Claims Examiner - Workers Compensation

Sedgwick

• Manages mid-level water damage claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. • Assesses liability and resolves claims within evaluation. • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. • Manages subrogation of claims and negotiates settlements. • Communicates claim action with claimant and client. • Ensures claim files are properly documented and claims coding is correct. • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. • Maintains professional client relationships. • Performs other duties as assigned. • Supports the organization's quality program(s).

Job Requirements

  • 4 years of Liability claims management experience or equivalent combination of education and experience required.
  • Bachelor's degree from an accredited college or university preferred.

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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