Claims Representative - Workers Compensation (REMOTE- NY License required; Exp in any of these:[...]

Sedgwick; Kentucky; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading insurance provider is seeking a Claims Representative to process workers compensation claims. The ideal candidate will possess a New York License and have at least two years of claims management experience. Responsibilities include determining benefits, coordinating action plans, and negotiating settlements. This role supports a flexible work schedule and offers comprehensive benefits including medical and a 401K starting on day one.

Benefits

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits including medical, dental, vision, and 401K

Qualifications

• Two years of Workers Compensation claims management experience or equivalent.
• Experience with claims handling in PA, IN, MA, MI, or OR required.
• New York License required.

Responsibilities

• Process low level workers compensation claims determining benefits due.
• Coordinate claims' action plans to resolution and return-to-work efforts.
• Negotiate settlements for claims under supervision.
• Communicate claim actions with claimants and clients.

Skills

Empathy

Accountability

Collaboration

Negotiation

Education

Bachelor's degree from an accredited college or university

Job description

Overview

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

Role: Claims Representative - Workers Compensation (REMOTE- NY License required; Exp in any of these: PA, IN, MA, MI, OR IN preferred)

Ideal Candidate

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

Primary Purpose: 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.

Essential Functions and Responsibilities

• 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.

Additional 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; NY License Required

Experience:

Two (2) years of Workers Compensation claims management experience or equivalent combination of education and experience required. Claims handling in any of the following PA, IN, MA, MI, or OR IN

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.

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.