Remote Workers’ Comp Claims Adjuster – Growth & Impact

Sedgwick; Moline (IL); A distancia; USD 60.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Flexible work schedule

Referral incentive program

Agile environment

Career development and growth

Comprehensive benefits (medical, etc.)

Descripción de la vacante

Sedgwick, a global leader in claims management, seeks a Claims Adjuster for Workers' Compensation with jurisdiction coverage including MI, TX, IN, IL, and OH. This remote role analyzes mid- to high-level claims, determines benefits, and negotiates settlements while coordinating return-to-work efforts and ensuring proper documentation.

Ideal candidates bring 4+ years of claims experience, a bachelor's degree, and licensing readiness.

Formación

• Education and Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Four (4) years of claims management experience or equivalent combination of education and experience required.
• 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.

Educación

Bachelor's degree from an accredited college or university

Professional certification as applicable to line of business

Descripción del empleo

Sedgwick, a global leader in claims management, seeks a Claims Adjuster for Workers' Compensation with jurisdiction coverage including MI, TX, IN, IL, and OH. This remote role analyzes mid- to high-level claims, determines benefits, and negotiates settlements while coordinating return-to-work efforts and ensuring proper documentation.

Ideal candidates bring 4+ years of claims experience, a bachelor's degree, and licensing readiness.