Workers Compensation Claims Representative – Multiple Jurisdictions & Licensing Required

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⚜️ Louisiana, New Jersey, +3 more states – Remote

⚜️ Louisiana – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🏰 Missouri – Remote 🎸 Tennessee – Remote

💵 $42k - $55k / year

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏢 Enterprise

📋 Compliance

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.

📋 Description

• Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements. • Ensure compliance with multiple state workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements. • Negotiate settlements of claims within designated authority to reach claim resolution. • Provide clear and effective communication with the claimant and client. • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. • Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.

🎯 Requirements

• Minimum of (1) year of workers' compensation claims handling experience. • Experience with Medical Only & Minor Lost-Time • High school diploma or equivalent; a college degree or relevant certifications including licensing. • Licensed with strong understanding of workers' compensation claims processes, policies, and legal requirements. • Excellent written and verbal communication skills. • Strong analytical skills with attention to detail and accuracy. • Ability to manage multiple claims simultaneously and prioritize workload effectively. • Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook). • Ability to negotiate settlements and resolve claims disputes effectively.

🏖️ Benefits

• Referral incentive program • Opportunity to work in remote environment • Career development and promotional growth opportunities • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.