Workers Compensation Claims Adjuster

3 weeks ago


Los Angeles, California, United States Sedgwick Full time

About the Role

We are seeking a skilled Workers Compensation Claims Adjuster to join our team at Sedgwick. As a key member of our claims management team, you will be responsible for analyzing and managing workers compensation claims to ensure timely and accurate resolution.

Key Responsibilities

  • Analyze and determine compensability and benefits due on long-term indemnity claims
  • Manage claims action plans to resolution, coordinate return-to-work efforts, and approve claim payments
  • Process assigned claims, determine benefits due, and manage action plans pursuant to the claim or client contract
  • Manage subrogation of claims and negotiate settlements
  • Communicate claim action with claimants and clients
  • Ensure claim files are properly documented and claims coding is correct

Requirements

  • Bachelor's degree from an accredited college or university preferred
  • Four (4) years of claims management experience or equivalent combination of education and experience required
  • 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

About Sedgwick

Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. We are committed to delivering exceptional service and support to our clients and colleagues. If you are a motivated and detail-oriented individual with a passion for claims management, we encourage you to apply for this exciting opportunity.


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