Workers' Compensation Consultant

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August 29

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Sedgwick

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Insurance • Enterprise • Compliance

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

10,000+ employees

🏢 Enterprise

📋 Compliance

📋 Description

• Analyzes 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 resolution. • Review decisions made by Provincial Worker Compensation Boards and determine if decisions are appropriate and within the legislation. • Provide claim analysis to client to determine if decisions require formal appeal. • Manages the litigation process; ensures timely and cost- effective claims resolution. • Coordinates vendor referrals for additional investigation and/or litigation management. • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. • Ensures claim files properly documented and claims coding is correct. • Refers cases as appropriate to supervisor and management. • Provide analysis of financial / loss experience / premium data to assist in reducing claim cost for clients. • Travel as required.

🎯 Requirements

• Bachelor’s degree from an accredited college or university preferred. • Professional certification as applicable to line of business preferred. • Minimum five (5) years of claims management experience or equivalent combination of education and experience required. • Knowledge of legislation of Provincial WC Boards. • PC literate, including Microsoft Office products. • Excellent oral and written communication, including presentation skills. • Analytical and interpretive skills. • Strong organizational and interpersonal skills. • Excellent negotiation skills.