Entry-Level Workers' Compensation Claims Representative
Sedgwick is the world’s largest claims administrator, servicing the various benefit and insurance claims for three-quarters of the nation’s Fortune 100 and 500 companies such as: Amazon, Apple, Microsoft, eBay, Google, American Airlines, United Airlines, Starbucks, Boeing, Walmart, FedEx.
For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or man-made disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.
PRIMARY PURPOSE: To be oriented and trained as new industry professional with the ability to analyze workers compensation, general liability or disability claims and determine benefits due.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Attendance and completion of designated classroom claims professional training program.
Performs on-the-job training activities including:
- Investigate workers' compensation claims filed to determine if injury or illness is work-related. Investigation may include taking phone statements, reviewing accident report, reviewing prior medical records, and reviewing background check. No outside field work is required.
- Calculate workers' compensation disability benefits and setting appropriate financial reserves.
- Establish medical diagnosis and treatment plan, and monitoring medical progress via regular medical reports received. If medical progress is delayed, assess for setting a 2nd opinion medical evaluation and/or assigning for surveillance to a field investigator.
- Strategize and coordinate file information with defense counsel for informal claim settlement or trial hearing.
- Explaining workers' compensation benefits and process with injured workers.
- Pursuing 3rd party civil recoveries with or without subrogation counsel when injuries are caused by a negligent third party.
- Present cases in front of client representatives: risk management, disability manager, legal counsel and others.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Bachelor's degree from an accredited college or university preferred or equivalent experience as outlined below.
EXPERIENCE
No experience required with college degree. State license, self-insured certificate, WCCA/WCCP designation, or completion of the Sedgwick Claims Progression Program required without a degree. Prior claims experience preferred.
SKILLS AND KNOWLEDGE
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Paid training starting at $54K per year; with medical/dental/vision/401K match and 6 month performance reviews.
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Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.