Workers' Comp Claims Consultant II

Sedgwick; United States; Remote; USD 55,000 - 60,000; Full time

Benefits offered by this job

Travel as required

Job summary

Sedgwick, United States, is hiring a Level 2 Workers' Compensation Consultant to analyze mid- and senior-level workers' compensation claims and determine benefits due. You will ensure adjudication aligns with company standards and industry best practices while identifying subrogation opportunities and negotiating settlements.

Responsibilities include managing long-term indemnity claims, coordinating return-to-work efforts, approving payments, documenting files, and maintaining strong client

Qualifications

• Bachelor's degree preferred or equivalent combination of education and experience.
• Four years of claims management experience or equivalent.
• Strong communication and negotiation abilities.
• Knowledge of regulations, offsets, disability duration, and medical management practices.

Responsibilities

• Manage workers' compensation claims, determine compensability, and monitor reserves.
• Develop action plans and coordinate return-to-work efforts.
• Approve and process claims, determine benefits due, and manage client contracts.
• Oversee subrogation of claims and negotiate settlements.
• Communicate claim actions with claimants and clients.
• Ensure proper documentation and accurate claim coding.
• Handle complex lifetime medical or defined period medical claims as needed.
• Maintain professional relationships with clients.

Skills

Communication skills

Analytical skills

Negotiation skills

Team player

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Sedgwick, United States, is hiring a Level 2 Workers' Compensation Consultant to analyze mid- and senior-level workers' compensation claims and determine benefits due. You will ensure adjudication aligns with company standards and industry best practices while identifying subrogation opportunities and negotiating settlements.

Responsibilities include managing long-term indemnity claims, coordinating return-to-work efforts, approving payments, documenting files, and maintaining strong client