Claims Adjuster - Workers Comp

Claims Adjuster - Workers Comp

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

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. Ensures claim files are properly documented and claims coding is correct. May process complex 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.

QUALIFICATIONS

Education & Licensing: 4 years of claims management experience or equivalent combination of education and experience required. 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.

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, 401(k) on day one. Work environment requirements for entry‑level opportunities include – Physical: Computer keyboarding. Auditory/visual: Hearing, vision, and talking. Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines. 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 $68,000 - $80,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always accepting applications. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. #J-18808-Ljbffr Sedgwick