Claims Examiner - Workers Compensation | Jurisdiction: WA | Licensing: Preferred

Overview Primary purpose of the role: We are looking for driven individuals that embody our caring counts model and core values of empathy, accountability, collaboration, growth, and inclusion. Responsibilities Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim. Manage claims through well-developed action plans to an appropriate and timely resolution. Negotiate settlement of claims within designated authority. Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim. Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level. Prepare necessary state filings within statutory limits. Manage the litigation process; ensure timely and cost-effective claims resolution. Coordinate vendor referrals for additional investigation and/or litigation management. Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets. Report claims to the excess carrier; respond to requests for directions in a professional and timely manner. Communicate claim activity and processing with the claimant and the client; maintain professional client relationships. Ensure claim files are properly documented and claims coding is correct. Refer cases as appropriate to supervisor and management. Perform other duties as assigned. Support the organization's quality program(s). Travel as required. Qualifications Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Five years of claims management experience or equivalent combination of education and experience required. Knowledge of WA jurisdiction; licensing in WA. Benefits Flexible work schedule. Referral incentive program. Opportunity to work in an agile environment. Career development and promotional growth opportunities. Diverse and comprehensive benefits, including medical, dental, vision, and 401(k) from day one. Work Environment Consideration given to reasonable accommodations when applicable and appropriate. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress and multiple priorities simultaneously. Physical: Computer keyboarding; travel as required. Auditory/Visual: Hearing, vision, and talking. Equal Employment Opportunity Statement Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. #J-18808-Ljbffr