Claims Adjuster - Workers Comp (Remote)
Company: Sedgwick
Location: Harrisburg
Posted on: January 17, 2023
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Job Description:
Taking care of people is at the heart of everything we do, and
we start by taking care of you, our valued colleague. A career at
Sedgwick means experiencing our culture of caring. It means having
flexibility and time for all the things that are important to you.
It's an opportunity to do something meaningful, each and every day.
It's having support for your mental, physical, financial and
professional needs. It means sharpening your skills and growing
your career. And it means working in an environment that celebrates
diversity and is fair and inclusive.A career at Sedgwick is where
passion meets purpose to make a positive impact on the world
through the people and organizations we serve. If you are someone
who is driven to make a difference, who enjoys a challenge and
above all, if you're someone who cares, there's a place for you
here. Join us and contribute to Sedgwick being a great place to
work.Great Place to Work -Most Loved Workplace -Forbes
Best-in-State EmployerClaims Adjuster - Workers Comp (Remote)**This
role is open to a work-at-home, remote, telecommuter, stay-at-home
setting*.****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.+ _As required by
law, Sedgwick provides a reasonable range of compensation for roles
that may be hired in (Colorado or New York City). 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 state noted in this job posting only, the range
of starting pay for this role is $50,000-$60,000. 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._\#LI-REMOTE
#LI-ONSITE #LI-CL1*subject to change based on company needsSedgwick
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.****Taking care of
people is at the heart of everything we do. Caring counts**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.
(https://www.youtube.com/watch?v=ywxedjBGSfA)
Keywords: Sedgwick, Harrisburg , Claims Adjuster - Workers Comp (Remote), Other , Harrisburg, Pennsylvania
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