Workers' Comp Claims Examiner - Flexible Growth

Sedgwick Claims Management Services Ltd; Chicago (IL); Hybride; USD 70 000 - 85 000; Plein temps

Avantages offerts par ce poste

Flexible schedule

Referral incentive program

Career development opportunities

Benefits on day one

Résumé du poste

Sedgwick is seeking a Claims Examiner - Workers Compensation in Chicago, IL to analyze complex workers' compensation claims and determine benefits due. You will handle high-exposure claims, coordination with litigation and rehabilitation, and subrogation where applicable.

We value empathy, accountability, collaboration, growth, and inclusion, with a stable office environment, flexible schedule, and a comprehensive benefits package. Join a caring culture and grow your career with Sedgwick.

Qualifications

• 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.

Responsabilités

• 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.

Connaissances

Claims management

Analytical thinking

Problem solving

Communication

Formation

High School Diploma or GED

Bachelor's degree

Professional certification applicable to line of business

Description du poste

Sedgwick is seeking a Claims Examiner - Workers Compensation in Chicago, IL to analyze complex workers' compensation claims and determine benefits due. You will handle high-exposure claims, coordination with litigation and rehabilitation, and subrogation where applicable.

We value empathy, accountability, collaboration, growth, and inclusion, with a stable office environment, flexible schedule, and a comprehensive benefits package. Join a caring culture and grow your career with Sedgwick.