Remote Workers’ Comp Claims Adjuster

Sedgwick; Santa Fe (NM); A distancia; USD 60.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Flexible schedule

Referral program

Agile environment

Career development

Benefits package

Descripción de la vacante

Sedgwick is hiring a Claims Adjuster - Workers' Compensation for a remote US role. The ideal candidate will analyze mid- to high-level workers compensation claims, determine benefits due, and manage subrogation and settlements. Licensing is required in the home state, with jurisdiction coverage MI, TX, IN, IL, OH.

Four years of claims management experience and a bachelor's degree are preferred. Sedgwick offers a comprehensive benefits package and a flexible work schedule as part of a diverse,

Formación

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of claims management experience or equivalent.
• Jurisdiction knowledge: MI, TX, IN, IL, OH.
• Licensing: Home State Required.

Responsabilidades

• 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.
• Ensures claim files are properly documented and claims coding is correct.
• May process complex 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.

Conocimientos

Claims adjudication

Workers' compensation knowledge

Analytical thinking

Communication

Educación

Bachelor's degree

Descripción del empleo

Sedgwick is hiring a Claims Adjuster - Workers' Compensation for a remote US role. The ideal candidate will analyze mid- to high-level workers compensation claims, determine benefits due, and manage subrogation and settlements. Licensing is required in the home state, with jurisdiction coverage MI, TX, IN, IL, OH.

Four years of claims management experience and a bachelor's degree are preferred. Sedgwick offers a comprehensive benefits package and a flexible work schedule as part of a diverse,