Talent.com
Claims Examiner - Workers Compensation (REMOTE - VA, MD & DC exp needed)

Claims Examiner - Workers Compensation (REMOTE - VA, MD & DC exp needed)

SedgwickProvo, UT, US
2 days ago
Job type
  • Full-time
  • Remote
Job description

Claims Examiner - Workers Compensation

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?

  • Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
  • 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 : 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 Workers Compensation 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.

    As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80-85K annually. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

    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 Examiner • Provo, UT, US

    Related jobs
    • Promoted
    Insurance Benefits Specialist- 100% Remote

    Insurance Benefits Specialist- 100% Remote

    Global EliteProvo, UT, 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: 18 days ago
    • Promoted
    Travel CT Tech - $2,478 per week in Salt Lake City, UT

    Travel CT Tech - $2,478 per week in Salt Lake City, UT

    AlliedTravelCareersProvo, Utah, US
    Full-time
    AlliedTravelCareers is working with Windsor Healthcare Recruitment Group, Inc.CT Tech in Salt Lake City, Utah, 84124!.Marks Hospital Taylorsville (FSED) TRAVEL-CT and X Ray TECH (727) (both certs...Show moreLast updated: 1 day ago
    Remote Insurance Broker

    Remote Insurance Broker

    Tipton AgencySalt Lake City, UT, US
    Remote
    Full-time +2
    Quick Apply
    The Tipton Agency (TA) is a leading provider of life insurance and retirement solutions.In partnership with a national brokerage, TA removes obstacles and provides extensive support, allowing agent...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Technologist

    Travel CT Technologist

    PRIDE HealthPayson, UT, US
    Full-time
    PRIDE Health is seeking a travel CT Technologist for a travel job in Payson, Utah.Job Description & Requirements.PRIDE Health is the minority-owned healthcare recruitment division of Pride Glob...Show moreLast updated: 12 days ago
    • Promoted
    • New!
    Senior Manager, Provider Claims Diagnostics

    Senior Manager, Provider Claims Diagnostics

    Utah StaffingSalt Lake City, UT, US
    Full-time
    Senior Manager, Accounts Receivable Diagnostics.At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about tr...Show moreLast updated: 10 hours ago
    Insurance Agent (PT / FT + Warm Leads)

    Insurance Agent (PT / FT + Warm Leads)

    SFG - Peterson AgencySalt Lake City, UT, US
    Full-time +1
    Quick Apply
    Companies Hiring The Most High-Paying Jobs In 2024," and listed on INC's "Top 5000 Fastest Growing Companies" for six years in a row, we have a proven system and are hiring hard-working, motivated ...Show moreLast updated: 30+ days ago
    • Promoted
    Claims Team Lead - Workers Compensation - Remote CO

    Claims Team Lead - Workers Compensation - Remote CO

    SedgwickSalt Lake City, UT, US
    Remote
    Full-time
    Claims Team Lead - 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 ar...Show moreLast updated: 3 days ago
    • Promoted
    Claims Examiner, Medical Only

    Claims Examiner, Medical Only

    AmTrust FinancialSouth Jordan, UT, United States
    Full-time
    The Workers' Compensation Claims Examiner, Medical Only team, plays a vital role in swiftly and efficiently investigating workers' compensation claims for injuries that need medical care, but don't...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Claims Examiner

    Claims Examiner

    NTT DATAProvo, UT, US
    Full-time
    Remote Claims Processing Associate.NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this role, the candidate will be responsible for : pr...Show moreLast updated: less than 1 hour ago
    • Promoted
    • New!
    Specialist, Claims Recovery (Remote)

    Specialist, Claims Recovery (Remote)

    Utah StaffingProvo, UT, US
    Remote
    Full-time
    Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, audit results, and federal regulations to determine ...Show moreLast updated: 22 hours ago
    Claims Service Representative

    Claims Service Representative

    Farm Bureau Financial ServicesUSA, Utah, Sandy
    Full-time +1
    Will be filled at the appropriate level based on experience • •.Do you thrive in a work environment where you must multi-task and have strong organization skills? Are you a go-getter with high initia...Show moreLast updated: 13 days ago
    • Promoted
    • New!
    Patient Account Associate Claims and EDI

    Patient Account Associate Claims and EDI

    Utah StaffingSalt Lake City, UT, US
    Full-time
    Responsible for processing all claims, electronic and paper, within EPIC and outside the clearinghouse.Monitor unbilled claims, maintaining and updating medical coverage. Process all claims in a tim...Show moreLast updated: 22 hours ago
    • Promoted
    Workers' Compensation Claims Adjuster [CONTRACT]

    Workers' Compensation Claims Adjuster [CONTRACT]

    Argonaut Management Services, IncSalt Lake City, UT, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show moreLast updated: 19 days ago
    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Peterson Life & WealthSalt Lake City, UT, 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
    • Promoted
    • New!
    (Remote) Claims Examiner - Workers Compensation | GA & RI Jurisdictions

    (Remote) Claims Examiner - Workers Compensation | GA & RI Jurisdictions

    Utah StaffingSalt Lake City, UT, US
    Remote
    Full-time
    Claims Examiner - Workers Compensation | GA & RI Jurisdictions.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: 10 hours ago
    • Promoted
    Workers' Compensation Claims Adjuster (CONTRACT)

    Workers' Compensation Claims Adjuster (CONTRACT)

    Argonaut Management Services, IncSalt Lake City, UT, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show moreLast updated: 19 days ago
    • Promoted
    Senior Claim Examiner II, CA

    Senior Claim Examiner II, CA

    AmTrust FinancialSouth Jordan, UT, United States
    Full-time
    US-CA-Irvine | US-UT-South Jordan | US-AZ-Scottsdale.AmTrust is actively seeking a skilled Resolution Examiner specializing in Workers' Compensation Claims. The primary focus will be on negotiating...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Workers Compensation Claims Examiner | NC, SC, KY, WV Jurisdictions | Remote

    Workers Compensation Claims Examiner | NC, SC, KY, WV Jurisdictions | Remote

    Utah StaffingSalt Lake City, UT, US
    Remote
    Full-time
    Workers Compensation Claims Examiner.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 un...Show moreLast updated: 10 hours ago