Claims Examiner Workers Compensation TX

PRIMARY PURPOSE OF THE ROLE

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education & licensing: 5 years of claims management experience or equivalent combination of education and experience required.

• High School Diploma or GED required. Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Texas license.

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

• Physical:
  Computer keyboarding.
• Auditory/visual:
  Hearing, vision and talking.
• Mental:
  Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

The starting pay for this role is $60,234–$85,000 per year.

A comprehensive benefits package is offered 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.