Claims Examiner - Workers Compensation
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Claims Examiner managing complex water damage claims for Sedgwick. Analyzing, negotiating, and ensuring timely adjudication of claims in a supportive environment.
Responsibilities:
- Manages mid-level water damage claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
- Assesses liability and resolves claims within evaluation.
- 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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Requirements:
- 4 years of Liability claims management experience or equivalent combination of education and experience required.
- Bachelor's degree from an accredited college or university preferred.
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.
Similar Jobs
Claims Specialist
Claims Specialist managing and resolving pharmacy claims efficiently at PharMerica. Collaborating with teams to enhance patient care through meticulous claims management.
Lost Time Claims Adjuster – Workers' Compensation
Managing lost time and medical only Workers' Compensation claims at Encova Insurance. Collaborating with various stakeholders and ensuring proper claim management.
Claims Specialist
Claims Specialist responsible for supporting Clinical Research billing and account review for Providence Health System. Reviewing clinical billing accuracy and compliance while collaborating with research entities.
Claims Coordinator I
Claims Coordinator I responsible for entering claims data into the system and supporting claim adjusters in a remote setting. Role involves administrative duties related to handling claims inquiries and notifications.
Field Property Claims Adjuster
Field Property Claims Adjuster for Farmers conducting virtual and on-site investigations of property damage. Negotiating settlements and engaging with stakeholders in claims process.
Claims Representative – Personal Property
Claims Representative investigating personal property damage claims for ClaimsPro LP in remote role while ensuring compliance with state regulations. Communication with insured and evaluative duties for claims settlement.
Field Property Claims Adjuster
Field Property Claims Adjuster conducting investigations on property damage for Farmers Insurance. Using software and customer service skills to negotiate settlements and represent the company.
Field Property Claims Adjuster
Field Property Claims Adjuster at Farmers visiting policyholders’ homes to investigate property damage claims. Utilizing claims handling software and negotiating settlements with customers.
Field Property Claims Adjuster
Field Property Claims Adjuster assessing property damage through investigations and engaging with various stakeholders. Conducting virtual and on-site visits to negotiate settlements for claims.
Field Property Claims Adjuster
Field Property Claims Adjuster at Farmers Insurance visiting policyholders’ homes to assess property damage and negotiate settlements. Engaging with a variety of stakeholders including claimants and law enforcement.
Field Property Claims Adjuster
Field Property Claims Adjuster conducting both virtual and on-site investigations of property damage for Farmers Insurance. Evaluating claims, negotiating settlements, and representing the company in public interactions.
Field Property Claims Adjuster
Field Property Claims Adjuster with Farmers Insurance conducting investigations and negotiating settlements for property damage. Requires travel to policyholders’ residences and a strong customer service focus.
Field Property Claims Adjuster
Field Property Claims Adjuster visiting policyholders to assess property damage and negotiate settlements. Join Farmers Insurance, a leader in providing peace of mind through insurance solutions.
Field Property Claims Adjuster
Field Property Claims Adjuster responsible for investigating property damage for a reputable insurance company. Engaging with policyholders and using claims software to write estimates and settle claims.
Claims Examiner Manager
Claims Examiner Manager supporting federal claims management program. Conducting claims intake, investigation, research, documentation, and case administration activities.
Claims Examiner I
Claims Examiner I conducting claims intake and investigation while ensuring compliance with procedures. Collaborating with senior claims personnel and maintaining electronic case files.
Claims Specialist
Claims Specialist processing Wellness and Hospital Indemnity insurance claims for Aflac. Providing customer service and documentation for policyholders while utilizing database systems.
Claims Examiner – Reinsurance
Claims Examiner (Reinsurance) responsible for overseeing reinsurance claims management and compliance. Collaborating with claims teams to support optimal recoveries and accurate reporting within the United States.
Revenue Cycle Claims Specialist
Revenue Cycle Claims Specialist optimizing revenue cycle operations for autism care providers at Finni Health. Collaborating with teams to enhance billing, claims processing, and compliance.
Bodily Injury Claims Adjuster, Trucking
Claims Adjuster handling commercial transportation claims for Reserv. Providing customer service and managing claims effectively with a focus on quick resolutions.