Remote Workers' Comp Claims Examiner AK

Sedgwick; Indianapolis (IN); Remote; USD 75.000 - 90.000; Vollzeit

Benefits dieser Stelle

Flexible work schedule

Career development

Comprehensive benefits including 401k

Zusammenfassung

Sedgwick is seeking a driven Claims Examiner for Workers' Compensation with remote flexibility. The role focuses on processing low level claims, adjudicating benefits, and coordinating action plans to support return-to-work efforts while maintaining client relationships.

Ideal candidates have 5 years of claims management experience and AK jurisdiction knowledge. A high school diploma is required, with a bachelor's degree preferred and relevant certifications encouraged.

Qualifikationen

• 5 years of claims management experience or equivalent combination of education and experience.
• 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.

Aufgaben

• 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.

Kenntnisse

Claims management experience

Analytical thinking

Problem solving

Ausbildung

High School Diploma or GED

Bachelor's degree preferred

Professional certification where applicable

Jobbeschreibung

Sedgwick is seeking a driven Claims Examiner for Workers' Compensation with remote flexibility. The role focuses on processing low level claims, adjudicating benefits, and coordinating action plans to support return-to-work efforts while maintaining client relationships.

Ideal candidates have 5 years of claims management experience and AK jurisdiction knowledge. A high school diploma is required, with a bachelor's degree preferred and relevant certifications encouraged.