Current jobs related to Claims Assessment Specialist - Charleston, West Virginia - Sedgwick

  • Claims Specialist III

    2 weeks ago


    Charleston, West Virginia, United States AIG Full time

    Job Title: Casualty Claims Specialist IIIWe are seeking a highly skilled and experienced Casualty Claims Specialist III to join our team at AIG. As a key member of our Claims department, you will play a critical role in managing and resolving complex auto and general liability claims.Key Responsibilities:Analyze and process 3rd party property damage claims,...

  • Claims Specialist III

    2 weeks ago


    Charleston, West Virginia, United States AIG Full time

    Job SummaryWe are seeking a highly skilled Claims Specialist III to join our team at AIG. As a key member of our Claims team, you will be responsible for handling auto and general liability claims under general supervision and moderate to high exposure claims involving litigation.Key ResponsibilitiesAnalyze and process 3rd party property damage claims by...


  • Charleston, West Virginia, United States Sentry Full time

    About the Role: We are seeking a highly skilled Claims Legal Specialist to join our team at Sentry. As a Claims Legal Specialist, you will provide expert technical guidance on the requirements to properly resolve conditional demands and participate in the development of technical content and implementation of training programs to ensure understanding of...


  • Charleston, West Virginia, United States Ally Full time

    The OpportunityJoin Ally's team as a Mechanical Claims Specialist and take your passion for automotive repair to the next level. As a key member of our team, you will work with dealerships, repair facilities, and customers to resolve claims and provide exceptional service.The Work ItselfUtilize your French language skills to communicate with customers and...

  • Claims Specialist

    4 weeks ago


    Charleston, West Virginia, United States Trustmark Full time

    Transform Lives with TrustmarkAt Trustmark, we're dedicated to improving wellbeing for everyone. Our mission is built on a foundation of equality and a culture of caring. We believe that by building trust, we can create a better world for our customers, communities, and employees.We're seeking a skilled Claims Analyst III to join our team. As a Claims...

  • Claims Investigator

    2 weeks ago


    Charleston, West Virginia, United States Allied Universal® Compliance and Investigations Full time

    Job SummaryJoin Allied Universal Compliance and Investigations as a Claims Investigator and take your career to the next level in insurance claims investigation. As a global leader in the industry, we offer dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our diverse and inclusive team is committed to...


  • Charleston, West Virginia, United States PURE Insurance Full time

    About the RoleThe Claims Representative is a key member of the claims team reporting to the Claims Representative Casualty Manager. The primary goal of this position is to deliver exceptional service to our members and independent agency partners.This person will handle first and third-party claims in a quality manner and meet our high standards of accuracy,...


  • Charleston, West Virginia, United States Encova Insurance Full time

    Job SummaryThe Engagement Center Representative provides exceptional customer service to clients by addressing their inquiries and concerns related to claims, medical billing, and policy information. This role involves interacting with customers via phone, email, or chat to resolve their issues and provide accurate information.Key ResponsibilitiesProvide...

  • Claims Investigator

    2 weeks ago


    Charleston, West Virginia, United States Allied Universal® Compliance and Investigations Full time

    Job SummaryAllied Universal Compliance and Investigations is seeking a skilled Claims Investigator to validate insurance losses through scene investigations, claimant and witness interviews, document retrieval, and data analysis.Key ResponsibilitiesInvestigate insurance claims for various coverage types, including workers' compensation, general liability,...


  • Charleston, West Virginia, United States PEOPLEASE Full time

    Position SummaryThe PEOPL EASE Group (TPG) is a leading Professional Employer Organization (PEO) serving 70,000 employees. TPG's industry focus and strategic growth plan have positioned us to be the leading provider of PEO services in the United States serving the blue and gray collar markets.We are seeking a skilled Workers Compensation Medical Only Claims...


  • Charleston, West Virginia, United States CAMC Health System Full time

    Job SummaryAs a Patient Accounts Resolution Specialist at CAMC Health System, you will play a critical role in ensuring that claims are paid accurately and timely. Your primary responsibility will be to review unpaid and underpaid claims, identify the root cause of issues, and work with various stakeholders to resolve them. This will involve collaborating...


  • Charleston, West Virginia, United States CommuniCare Family of Companies Full time

    Job SummaryThe Medical Billing Specialist role at CommuniCare Family of Companies is responsible for processing and managing medical claims for our facilities. This position requires strong attention to detail and excellent communication skills to interact with insurance companies and resolve unpaid claims.Key ResponsibilitiesProcess and manage medical...


  • Charleston, West Virginia, United States CAMC Health System Full time

    Job SummaryWe are seeking a highly skilled Patient Accounts Resolution Specialist to join our team at CAMC Health System. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving unpaid and underpaid claims in a timely and accurate manner.Key ResponsibilitiesReview assigned work items daily to resolve at-risk, past-due,...


  • Charleston, West Virginia, United States CAMC Health System Full time

    Job SummaryAs a Patient Accounts Resolution Specialist at CAMC Health System, you will play a critical role in ensuring that claims are paid accurately and timely. Your primary responsibility will be to review unpaid and underpaid claims, identify the root cause of issues, and work with various stakeholders to resolve them. This includes collaborating with...


  • Charleston, West Virginia, United States AssuredPartners Full time

    Job Title: Client Service SpecialistAssuredPartners is seeking a highly skilled Client Service Specialist to join our team. As a key member of our risk management team, you will be responsible for providing exceptional support to clients and team members in assessing risk-related matters and making recommendations for risk mitigation.Key...

  • Nurse Practitioner

    1 week ago


    Charleston, West Virginia, United States Matrix Medical Network Full time

    About UsMatrix Medical Network is a leading provider of clinical services and care management solutions. Our team of experienced clinicians is dedicated to delivering high-quality care to at-risk individuals and their families.We offer a comprehensive range of services, including home risk assessments, medical history reviews, and health education. Our goal...


  • Charleston, West Virginia, United States CommuniCare Family of Companies Full time

    Job Title: HR Benefits SpecialistWe are seeking a highly skilled HR Benefits Specialist to join our team at CommuniCare Family of Companies. As an HR Benefits Specialist, you will play a critical role in supporting employees with all matters related to insurance benefits.Job Summary:The HR Benefits Specialist will serve as a liaison for health plan...


  • Charleston, West Virginia, United States MUSC Full time

    {"Job Title": "Revenue Cycle Specialist", "Job Description": "Job SummaryThe Revenue Cycle Specialist plays a critical role in ensuring timely and accurate revenue posting. This position is responsible for entering charges, resolving issues, and reconciliations of charge postings at a detail level. The Specialist supports preauthorization workflow and...

  • Nurse Practitioner

    2 weeks ago


    Charleston, West Virginia, United States CAMC Health System Full time

    Job SummaryAs a Nurse Practitioner - Employee Health Specialist at CAMC Health System, you will play a vital role in providing high-quality healthcare services to employees who become ill or injured at work. Your expertise will be essential in developing and implementing an onsite treatment center to provide care for acute illness or injury, utilizing...


  • Charleston, West Virginia, United States CommuniCare Family of Companies Full time

    Job Title: HR Benefits SpecialistWe are seeking a highly skilled HR Benefits Specialist to join our team at CommuniCare Family of Companies. As an HR Benefits Specialist, you will play a critical role in supporting employees with all matters related to insurance benefits.Job Summary:The HR Benefits Specialist will serve as a liaison for health plan...

Claims Assessment Specialist

2 months ago


Charleston, West Virginia, United States Sedgwick Full time

About Us
At Sedgwick, we prioritize the well-being of our employees, fostering a culture that emphasizes care and support.

Career Overview
A position at Sedgwick offers a chance to engage in meaningful work while enjoying flexibility and support for your overall well-being. We are committed to nurturing your professional growth and celebrating diversity within our workforce.

Role Summary
The Claims Assessment Specialist is responsible for evaluating complex Workers Compensation claims on behalf of our esteemed clients. This role involves ensuring that claims are processed efficiently, adhering to service expectations and industry standards.

Key Responsibilities
1. Assess and manage claims through structured action plans to achieve timely resolutions by investigating and gathering necessary information.
2. Negotiate settlements within the designated authority.
3. Maintain clear communication regarding claim status with both claimants and clients.
4. Report claims to the appropriate excess carrier and respond to inquiries in a professional manner.

Qualifications
Education & Licensing: A minimum of 5 years of experience in claims management or a related field is required. A High School Diploma or GED is mandatory, while a Bachelor's degree is preferred. Relevant professional certifications are advantageous.

Licensing / Jurisdiction Knowledge
Possession of an active adjuster's license and experience with Workers Compensation claims in various jurisdictions is preferred.

Benefits
We offer a flexible work schedule, a referral incentive program, and opportunities for career advancement. Our comprehensive benefits package includes medical, dental, vision, and a 401K plan starting from day one.

Commitment to Diversity
Sedgwick is an Equal Opportunity Employer and values a diverse workforce. We encourage individuals from all backgrounds to apply, recognizing that unique skills and experiences contribute to our success.

Our Mission
Every day, we strive to support organizations and their employees, ensuring a seamless claims process while minimizing disruptions. At Sedgwick, we believe that caring counts.