Claims Examiner - Workers Compensation | Jurisdiction & Licensing: HI (Hybrid - Must Reside in Hawaii)

Sedgwick Claims Management Services Ltd; Honolulu (HI); Hybrid; USD 75,000 - 85,000; Full time

Benefits offered by this job

Hybrid work schedule

Medical, dental, vision

401K on day one

Referral incentive program

Job summary

Sedgwick Claims Management Services Ltd in Hawaii seeks a Claims Examiner - Workers Compensation to adjudicate complex WC claims in a hybrid, Honolulu-area role. Analyze claims, determine benefits, and ensure timely adjudication in line with client requirements.

You will negotiate settlements within authority, report to excess carriers, and coordinate with claimants and clients. Requires 5 years of claims management experience; HS diploma; Bachelor's preferred; Hawaii licensing preferred.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• 5 years of claims management experience or equivalent.

Responsibilities

• Analyze and process claims through well-developed action plans to determine exposure and timely resolution.
• Negotiate settlements within designated authority.
• Communicate claim activity with the claimant and the client.
• Report claims to the excess carrier and respond to directions in a professional and timely manner.

Education

High School Diploma or GED

Bachelor's degree

Job description

Claims Examiner - Workers Compensation | Jurisdiction & Licensing: HI (Hybrid - Must Reside in Hawaii)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 Claims Examiner, WC knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.* 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. **Office Location:** Hybrid 2 days in office, 3 days work from home. **PRIMARY PURPOSE OF THE ROLE** To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements**.** **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** * Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.* Negotiating settlement of claims within designated authority.* Communicating claim activity and processing with the claimant and the client.* Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.**QUALIFICATIONS** Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience: 5 years of claims management experience or equivalent combination of education and experience required. Licensing / Jurisdiction Knowledge:**Hawaii** **TAKING CARE OF YOU** * Flexible work schedule.* Referral incentive program.* Opportunity to work in an agile environment.* Career development and promotional growth opportunities.* A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.**WORK ENVIRONMENT REQUIREMENTS** **INCLUDE** When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking #claimsexaminer #claims #hybrid #LI-REMOTE #Sedgwick #Hotjobs 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 ($75k-85k). 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.