Claims Examiner - Workers Compensation | Jurisdiction & Licensing: SC & NC | Dedicated Client

Sedgwick; United States; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Comprehensive benefits: medical,Dental

Job summary

Sedgwick is hiring a Claims Examiner - Workers' Compensation to analyze claims for clients in SC and NC, determine benefits due, and adjudicate within service expectations.

You will negotiate settlements, communicate with claimants and clients, and collaborate with a broad network of professionals. Flexible hybrid work arrangement and strong development opportunities are offered.

Qualifications

• 5 years of claims management experience or equivalent.
• Education: HS diploma or GED; Bachelor’s degree preferred.
• Licensing knowledge for SC & NC jurisdictions.

Responsibilities

• Analyze and process workers' compensation claims to determine exposure and benefits.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to excess carriers and respond to directions promptly.

Skills

Claims analysis

Negotiation

Client communication

Education

High School Diploma or GED

Bachelor’s degree

Professional certification

Job description

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

Claims Examiner - Workers Compensation | Jurisdiction & Licensing: SC & NC | Dedicated Client

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?

• 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 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: SC & NC

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.

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

Sedgwickis 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.