We are seeking a highly motivated and experienced Workers' Compensation Claims Representatives to join our team. The ideal candidate will have at least 1 year of claims handling experience , with a strong background in jurisdictional regulations and processes. This position is responsible for managing and processing workers' compensation claims, ensuring timely and accurate decisions while adhering to all applicable laws and regulations.

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

ESSENTIAL RESPONSIBILITIES

• Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
• Ensure compliance with multiple state workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
• Negotiate settlements of claims within designated authority to reach claim resolution.
• Provide clear and effective communication with the claimant and client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
• Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.

QUALIFICATIONS

• Experience:
  • Minimum of (1) year of workers' compensation claims handling experience.
  • experience with Medical Only & Minor Lost-Time
• Education:
  • High school diploma or equivalent; a college degree or relevant certifications including licensing.
• Skills and Abilities:
  • Licensed with strong understanding of workers' compensation claims processes, policies, and legal requirements.
  • Excellent written and verbal communication skills.
  • Strong analytical skills with attention to detail and accuracy.
  • Ability to manage multiple claims simultaneously and prioritize workload effectively.
  • Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
  • Ability to negotiate settlements and resolve claims disputes effectively.

Jurisdictions: DE, IL, LA, MO, NJ, OK, TN, TX

Licensing: Home state required

TAKING CARE OF YOU

• Referral incentive program.
• Opportunity to work in remote environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTS INCLUDE
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

Auditory/Visual: Hearing, vision and talking

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 (42,000 - 55,000). 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.