Claims Adjuster - Workers Compensation (NC/SC/FL/GA licensing/experience) (Remote)
Posted on: January 24, 2023
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to you please use the 'Apply' option.**
Claims Adjuster - Workers Compensation (NC/SC/FL/GA
IF YOU CARE, THERE'S A PLACE FOR YOU HERE
For a career path that is both challenging and rewarding, join
Sedgwick's talented team of 27,000 colleagues around the globe.
Sedgwick is a leading provider of technology-enabled risk, benefits
and integrated business solutions. Taking care of people is at the
heart of everything we do. Millions of people and organizations
count on Sedgwick each year to take care of their needs when they
face a major life event or something unexpected happens. Whether
they have a workplace injury, suffer property or financial loss or
damage from a natural or manmade disaster, are involved in an auto
or other type of accident, or need time away from work for the
birth of a child or another medical situation, we are here to
provide compassionate care and expert guidance. Our clients depend
on our talented colleagues to take care of their most valuable
assets-their employees, their customers and their property. At
Sedgwick, caring counts. Join our team of creative and caring
people of all backgrounds, and help us make a difference in the
lives of others.
For more than 50 years, Sedgwick has been helping employers answer
virtually every question there is about workers' compensation. We
have experience in nearly every type of industry and region and
provide the industry's broadest range of programs and services.
**Florida, Georgia, South Carolina, North Carolina claims examiner
licensing and experience a plus!**
**This role is open to a work-at-home, remote, telecommuter,
**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
**PRIMARY PURPOSE** **:** 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; and to identify subrogation of claims and negotiate
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ 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
+ Approves and processes assigned claims, determines benefits due,
and manages action plan pursuant to the claim or client
+ Manages subrogation of claims and negotiates settlements.
+ Communicates claim action with claimant and client.
+ Ensures claim files are properly documented and claims coding is
+ 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
+ Maintains professional client relationships.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**Education & Licensing**
Bachelor's degree from an accredited college or university
Four (4) years of claims management experience or equivalent
combination of education and experience required.
**Skills & Knowledge**
+ Working knowledge of regulations, offsets and deductions,
disability duration, medical management practices and Social
Security and Medicare application procedure as applicable to line
+ Excellent oral and written communication, including presentation
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skill
+ Good interpersonal skills
+ Excellent negotiation skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
When applicable and appropriate, consideration will be given to
**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
**Physical** **:** Computer keyboarding, travel as required
**Auditory/Visual** **:** Hearing, vision and talking
**NOTE** **:** Credit security clearance, confirmed via a
background credit check, is required for this position.
The statements contained in this document are intended to describe
the general nature and level of work being performed by a colleague
assigned to this description. They are not intended to constitute a
comprehensive list of functions, duties, or local variances.
Management retains the discretion to add or to change the duties of
the position at any time.
*subject to change based on company needs.
Sedgwick is an Equal Opportunity Employer and a Drug-Free
**Taking care of people is at the heart of everything we do. Caring
Sedgwick is a leading global provider of technology-enabled risk,
benefits and integrated business solutions. Every day, in every
time zone, the most well-known and respected organizations place
their trust in us to help their employees regain health and
productivity, guide their consumers through the claims process,
protect their brand and minimize business interruptions. Our more
than 30,000 colleagues across 80 countries embrace our shared
purpose and values as they demonstrate what it means to work for an
organization committed to doing the right thing - one where caring
counts. Watch this video to learn more about us.
Keywords: Sedgwick, Greensboro , Claims Adjuster - Workers Compensation (NC/SC/FL/GA licensing/experience) (Remote), Other , Greensboro, North Carolina
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