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Workers Compensation Claims Adjuster

Full-time

Sedgwick

Role Description

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.

Qualifications

  • Bachelor's degree from an accredited college or university preferred; Home state license required.
  • One (1) year of claims management experience.
  • Prior handling of FL med only & indemnity claims.
  • Jurisdiction Knowledge: FL.
  • Licensing: FL.

Requirements

  • To analyze mid- and higher-level workers compensation claims to determine benefits due.
  • To ensure ongoing adjudication of claims within company standards and industry best practices.
  • To identify subrogation of claims and negotiate settlements.
  • Manages 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 manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.

Benefits

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

Work Environment Requirements

  • Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
  • Physical: Computer keyboarding.
  • Auditory/Visual: Hearing, vision and talking.
Vacancy posted 4 days ago
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