Talent.com
Claims Representative - Workers Compensation - Remote CO

Claims Representative - Workers Compensation - Remote CO

SedgwickPortland, OR, US
2 days ago
Job type
  • Full-time
  • Remote
Job description

Claims Representative - Workers Compensation - Remote CO

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

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
  • Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
  • Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path.
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Are you an ideal candidate? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Primary purpose of the role : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

Essential functions may include :

  • Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
  • Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
  • Administers 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 low-level 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).
  • Travels as required.
  • Qualifications & Licensing

    Education & Experience : Bachelor's degree from an accredited college or university preferred.

    Experience : Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

    Create a job alert for this search

    Claim Representative • Portland, OR, US

    Related jobs
    Benefits Representative (Remote)

    Benefits Representative (Remote)

    Globe Life AIL - McQuade OrganizationOregon City, OR, US
    Remote
    Full-time
    Quick Apply
    Job Description If you are interested in working with an amazing team, with full training from the ground up, weekly pay, and flexible hours. with the ability to work from home, read below.Weekly p...Show moreLast updated: 10 days ago
    • Promoted
    Share Your Thoughts, Pocket Some Cash : Join Opinion Outpost's Survey Opportunities!

    Share Your Thoughts, Pocket Some Cash : Join Opinion Outpost's Survey Opportunities!

    DynataSaint Helens, OR, US
    Full-time
    Ready to turn your opinions into cash? Explore the world of remote paid online survey gigs with Opinion Outpost!.It's as simple as sharing your thoughts from the comfort of your own home and watchi...Show moreLast updated: 3 days ago
    • Promoted
    Fully Remote Survey Participant

    Fully Remote Survey Participant

    Prime InsightsOak Hills, OR, US
    Remote
    Full-time
    Join thousands of members already earning with top-paying surveys and offers.Get started today and enjoy competitive rewards, fast payouts with no waiting periods, and the flexibility to participat...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Claims Examiner - General Liability | Hawaii License Required

    Claims Examiner - General Liability | Hawaii License Required

    Portland StaffingPortland, OR, US
    Full-time
    Claims Examiner - General Liability.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 une...Show moreLast updated: 2 hours ago
    • Promoted
    Admitting Representative

    Admitting Representative

    Hillsboro Medical CenterHillsboro, OR, US
    Full-time
    The Admitting Representative is a unique role that welcomes the patient into the care delivery setting, providing direction and assistance while ensuring customer satisfaction by offering solution ...Show moreLast updated: 30+ days ago
    • Promoted
    Landfill Sales Representative

    Landfill Sales Representative

    Waste ConnectionsLongview, Washington, United States
    Full-time
    Location : Employee may sit at our locations in Vancouver, WA, Longview, WA, or The Dalles, OR.Salary : $78,000 annually + commission plan and mileage reimbursement. Travel : Minimum once-a-month visits ...Show moreLast updated: 30+ days ago
    • Promoted
    Take Surveys Get Paid!

    Take Surveys Get Paid!

    Prime InsightsKelso, WA, US
    Full-time
    Join thousands of members already earning with top-paying surveys and offers.Get started today and enjoy competitive rewards, fast payouts with no waiting periods, and the flexibility to participat...Show moreLast updated: 3 days ago
    • Promoted
    Freelance Data Collector

    Freelance Data Collector

    Prime InsightsSandy, OR, US
    Full-time
    Join thousands of members already earning with top-paying surveys and offers.Get started today and enjoy competitive rewards, fast payouts with no waiting periods, and the flexibility to participat...Show moreLast updated: 3 days ago
    • Promoted
    Claims Clerk

    Claims Clerk

    Oregon StaffingLake Oswego, OR, US
    Full-time
    The Claims Clerk will review insurance claims forms and documents for accuracy and completion and obtain missing information as necessary. Determines claims coverage by examining company records.Int...Show moreLast updated: 11 days ago
    • Promoted
    Travel Physical Therapist (PT) - $1,866 per week in Saint Helens, OR

    Travel Physical Therapist (PT) - $1,866 per week in Saint Helens, OR

    AlliedTravelCareersSaint Helens, OR, US
    Full-time
    AlliedTravelCareers is working with Prime HealthCare Staffing to find a qualified Physical Therapist (PT) in Saint Helens, Oregon, 97051!. Prime HealthCare Staffing, a national health care staffing ...Show moreLast updated: 10 days ago
    • Promoted
    Claims Examiner - Workers Compensation - Portland, OR - Hybrid

    Claims Examiner - Workers Compensation - Portland, OR - Hybrid

    Portland StaffingPortland, OR, US
    Full-time
    Claims Examiner - Workers Compensation - Portland, OR - Hybrid.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 w...Show moreLast updated: 1 day ago
    • Promoted
    Claims Examiner - Workers Compensation - Portland, OR - Hybrid

    Claims Examiner - Workers Compensation - Portland, OR - Hybrid

    SedgwickPortland, OR, US
    Full-time
    Claims Examiner - Workers Compensation - Portland, OR - Hybrid.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 w...Show moreLast updated: 29 days ago
    • Promoted
    Requisition Senior Claim Examiner II, CA

    Requisition Senior Claim Examiner II, CA

    AmTrust Financial ServicesPortland, OR, US
    Full-time
    The Resolution Adjuster is responsible for prompt and independent review of insurance claims, through effective research, evaluation, investigation, negotiation and interaction with insureds, claim...Show moreLast updated: 3 days ago
    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Peterson Life & WealthPortland, OR, US
    Remote
    Full-time +1
    Quick Apply
    Time freedom, uncapped income, and a team that actually has your back.Join our incredible culture of experienced agents ready to help you take the next step! 🐘 Peterson Life & Wealth is...Show moreLast updated: 30+ days ago
    Entry-Level Remote Sales

    Entry-Level Remote Sales

    Wood Agency LifeKelso, WA, us
    Remote
    Full-time
    Quick Apply
    Are you ready to break into sales and start a new career — all from the comfort of your home? We’re looking for.Life Insurance Sales Representatives. Must be 18+ and authorized to work in the U.Comf...Show moreLast updated: 2 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    CorVelPortland, OR, US
    Full-time
    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, un...Show moreLast updated: 30+ days ago
    • Promoted
    Senior Compensation Consultant •Remote •

    Senior Compensation Consultant •Remote •

    Oregon StaffingPortland, OR, US
    Remote
    Full-time
    Senior Compensation Consultant.The Senior Compensation Consultant plays a vital role in the development and ongoing administration, design, analysis and implementation of Providence's union and non...Show moreLast updated: 11 days ago
    • Promoted
    Insurance Benefits Specialist- 100% Remote

    Insurance Benefits Specialist- 100% Remote

    Global ElitePortland, OR, US
    Remote
    Full-time
    Insurance Benefits Specialist- 100% Remote.Now is the best time to join full-time remote completely work from home.All benefits representatives start at entry level and move up! Suggested schedule ...Show moreLast updated: 30+ days ago