Workers Compensation Claims Representative | Medical Only Workers Compensation | VA Jurisdiction

Sedgwick; Virginia (IL); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits package

Job summary

Sedgwick is seeking a dedicated Claims Examiner for Medical Only Workers Compensation in the VA jurisdiction. You will adjudicate complex claims, negotiate settlements, and communicate with claimants and clients while leveraging a broad national network.

The role emphasizes empathy, accuracy, and timely resolutions. Qualifications include 2+ years in claims management or equivalent, a high school diploma (bachelor's preferred), and a commitment to Sedgwick’s care-driven culture.

Qualifications

• 2 years of claims management experience or equivalent combination of education and experience required.
• Medical Only: Worker’s Compensation knowledge preferred.
• Bachelor's degree from an accredited college or university preferred.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

Claims management

Medical-only

Communication

Education

High School Diploma

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation Claims Representative | Medical Only Workers Compensation | VA Jurisdiction

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.

ARE YOU AN IDEAL CANDIDATE?

To process low level MEDICAL ONLY Workers Compensation claims for a Dedicated Client to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

PRIMARY PURPOSE OF THE ROLE:

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Essential Responsiblities May Include

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Qualifications

• Education & Licensing: 2 years of claims management experience or equivalent combination of education and experience required.
• Medical Only
• 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.

Jurisdiction Knowledge: VA

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (45,000-60,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claims #claimsexaminer

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.