Claims Adjuster - Workers Compensation
Company: Sedgwick
Location: Biloxi
Posted on: August 3, 2022
|
|
Job Description:
**The 'Apply with SEEK' option will be utilized for
International applicants, mainly Australia. If this does not apply
to you please use the 'Apply' option.**Claims Adjuster - Workers
CompensationIF YOU CARE, THERE'S A PLACE FOR YOU HEREFor 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.**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 settlements.**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 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.**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**+
Performs other duties as assigned.+ Supports the organization's
quality program(s).+ Travels as
required.**QUALIFICATIONS****Education & Licensing**Bachelor's
degree from an accredited college or university
preferred.**Experience**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 of business+ Excellent oral and written
communication, including presentation skills+ 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**WORK
ENVIRONMENT**When applicable and appropriate, consideration will be
given to reasonable accommodations.**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 deadlines**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.Sedgwick is an Equal
Opportunity Employer and a Drug-Free Workplace.
Keywords: Sedgwick, Biloxi , Claims Adjuster - Workers Compensation, Other , Biloxi, Mississippi
Click
here to apply!
|