Claim Examiner - Workers Comp (Southeast Experience Required)

Claim Examiner - Workers Comp (Southeast Experience Required)

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 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

To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

Essential Functions and Responsibilities

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution.

Additional Functions and Responsibilities

Performs other duties as assigned. Supports the organization's quality program(s). Travels as required.

Qualifications

Education & Licensing : Bachelor's degree from an accredited college or university preferred. Experience : Five (5) years of claims management experience or equivalent combination of education and experience required.

Taking Care Of You

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.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.