Claims Examiner - Workers Compensation - Midwest Jurisdictions - Chicago, IL, or Remote in MN, MI, MO, IN, WI

Work set-up: 
Full Remote
Contract: 
Salary: 
68 - 68K yearly
Experience: 
Mid-level (2-5 years)

Offer summary

Qualifications:

High School Diploma or GED required, Bachelor's degree preferred., At least 3 years of claims management experience or equivalent., Knowledge of workers' compensation claims processing and relevant jurisdiction laws., Professional certification related to claims management is a plus..

Key responsibilities:

  • Analyze and process workers' compensation claims to determine benefits due.
  • Investigate claims and gather information to assess exposure and resolve issues.
  • Communicate with claimants, clients, and external parties regarding claim status.
  • Manage claim recoveries, negotiate settlements, and ensure proper documentation.

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Sedgwick Ireland Startup https://www.sedgwick.com/
201 - 500 Employees
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Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation - Midwest Jurisdictions - Chicago, IL, or Remote in MN, MI, MO, IN, WI

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?  

  • 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. 

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
  • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
  • Managing claim recoveries if applicable.
  • Negotiating settlement of claims within designated authority.
  • Referring cases as appropriate to supervisor and management.
  • Calculating and assigning timely and appropriate reserves to claims.
  • Ensuring claim files are properly documented and claims coding is correct.
  • Communicating claim activity and processing with the claimant and the client.

QUALIFICATIONS & LICENSING

Education / Experience: 3+ 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.


Licensing / Jurisdiction Knowledge: IA, IL, IN, MI, MN, MO, NE, WI

TAKING CARE OF YOU

  • Flexible Work Schedule
  • Referral Incentive Program
  • Opportunity to work from home
  • Career development and promotional growth opportunities
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1

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 - $75,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Negotiation
  • Empathy
  • Accountability
  • Collaboration

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