[Remote] Workers Compensation Claims Examiner | Dedicated Account | 3 Days Remote

Note: The job is a remote job and is open to candidates in USA. Sedgwick is a global industry leader in claims management services. The Workers Compensation Claims Examiner will analyze complex claims, negotiate settlements, and ensure timely resolution while maintaining professional relationships with clients and claimants.ResponsibilitiesAnalyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolutionNegotiates settlement of claims within designated authorityCalculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claimCalculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority levelPrepares necessary state fillings within statutory limitsManages the litigation process; ensures timely and cost effective claims resolutionCoordinates vendor referrals for additional investigation and/or litigation managementUses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clientsManages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsetsReports claims to the excess carrier; responds to requests of directions in a professional and timely mannerCommunicates claim activity and processing with the claimant and the client; maintains professional client relationshipsEnsures claim files are properly documented and claims coding is correctRefers cases as appropriate to supervisor and managementSkillsFive (5) years of claims management experience or equivalent combination of education and experience requiredCalifornia jurisdictional knowledge requiredSIP required or must be obtained within one (1) year of employmentBachelor's degree from an accredited college or university preferredProfessional certification as applicable to line of business preferredBenefitsMedicalDentalVision401K on day onePTODisability and life insuranceEmployee assistanceFlexible spending or health savings accountOther additional voluntary benefitsCompany OverviewSedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.sedgwick.com.