Claims Representative - Workers Compensation | Jurisdiction: AK | Licensing: AK

Position Claims Representative – Workers Compensation (AK) PRIMARY PURPOSE OF THE ROLE To process low‑level workers compensation claims to determine benefits due; ensure ongoing adjudication of claims within company standards and industry best practices; identify subrogation opportunities and negotiate settlements under general supervision. RESPONSIBILITIES Process low‑level workers compensation claims, determine compensability and benefits due. Monitor reserve accuracy and file necessary documentation with state agencies. Develop and coordinate low‑level claim action plans to resolution, including return‑to‑work efforts. Approve and process assigned claims, determine benefits, and administer action plans per client contract. Administer subrogation of claims and negotiate settlements. Communicate claim actions with claimant and client. Ensure claim files are properly documented and coding is correct. Process low‑level lifetime medical and/or defined period medical claims, including state and physician filings and decisions on appropriate treatments. Maintain professional client relationships. QUALIFICATIONS 2years 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 applicable to the line of business preferred. Knowledge of AK jurisdiction and licensing. BENEFITS AND WORK ENVIRONMENT Flexible work schedule, referral incentive program, and opportunity to work in an agile environment. Career development and promotional growth opportunities. Diverse and comprehensive benefits package including medical, dental, vision, and 401(k) available on day one. COMPLIANCE When applicable, consideration will be given to reasonable accommodations. Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. #J-18808-Ljbffr