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Claims Adjuster - Workers Compensation (REMOTE - Home State Lic, Med Only & Indemnity exp REQUIRED in: IL, MO, NJ, OK, NJ, TN)***Home State Lic, Med Only & Indemnity exp REQUIRED in: IL, MO, NJ, OK, NJ, TN***
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?
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 mid- and higher-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
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Manages 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 manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
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.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university preferred; Home state license required
Experience:
Four (4) years of claims management experience
Prior handling of med only & indemnity claims, some litigation experience. Multiple jurisdictions including any of the following: IL, MO, NJ, OK, NJ, TN.
TAKING CARE OF YOU
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.