Claims Representative - Workers Compensation

Sedgwick; West Des Moines (IA); On-site; USD 46,000 - 65,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development

Comprehensive benefits

Job summary

Sedgwick is hiring a Claims Representative - Workers Compensation in the United States to adjudicate low level workers' compensation claims and determine benefits under supervision. The role emphasizes empathy, accountability, and service across a global client base, offering development opportunities and a flexible benefits package.

Expect travel as needed and professional growth within a respected leader in risk, claims, and brokering solutions.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
• Jurisdiction Knowledge: Colorado preferred.
• Licensing: Texas or Indiana license that can reciprocate preferred.

Responsibilities

• Processes low level workers compensation claims determining compensability and benefits due, under supervision.
• Negotiates settlements with general supervision.
• Maintains professional client relationships and documents claim actions clearly.
• Administers subrogation and coordinates action plans for resolution.
• Communicates claim actions with claimants and clients.
• Supports the organization's quality program and travels as required.

Skills

Claims management

Education

Bachelor's degree

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 Representative - Workers Compensation

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?

To process low 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 with general supervision.

PRIMARY PURPOSE OF THE ROLE

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Processes low level 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 coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.
• 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

• Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

Jurisdiction Knowledge: Colorado preferred.

Licensing: Texas or Indiana license that can reciprocate preferred.

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.

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 ( $ 46,125.00 - $64,575.00) . 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.