Claims Representative – Workers Comp, some experience needed

Posted 39ds ago

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Job Description

Claims Representative handling workers compensation claims for a leading risk and claims administration company. Processing claims, determining benefits, and communicating with claimants and clients.

Responsibilities:

  • To process low 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 with general supervision.
  • Processes low level 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 coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
  • Communicates claim action with claimant and client.

Requirements:

  • Bachelor's degree from an accredited college or university preferred.
  • Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

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.

Sedgwick

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