Workers' Compensation Specialist

6 days ago

Buffalo, New York, United States Sedgwick Full time
About the Role

We are seeking a highly skilled and experienced Claims Examiner to join our team at Sedgwick. As a Claims Examiner, you will play a critical role in analyzing and managing workers' compensation claims to ensure that our clients receive the benefits they deserve.

Key Responsibilities
  • Analyze and evaluate workers' compensation claims to determine benefits due and ensure ongoing adjudication within company standards and industry best practices.
  • Develop and manage action plans to resolution, coordinate return-to-work efforts, and approve claim payments.
  • Manage subrogation of claims and negotiate settlements.
  • Communicate claim actions 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.
Work Environment

This role requires a high level of attention to detail, excellent analytical and problem-solving skills, and the ability to work in a fast-paced environment. The successful candidate will be able to work independently and as part of a team, and will have excellent communication and interpersonal skills.

What We Offer

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. We offer a comprehensive benefits package, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

We are an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role and have the skills and experience we're looking for, we encourage you to apply.

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