Claims Examiner - Workers Compensation | Jurisdiction: WA or OR | Licensing: Required
About The Position
The Claims Examiner analyzes Workers Compensation claims on behalf of clients to determine benefits due and ensure ongoing adjudication within service expectations, industry best practices, and specific client service requirements. The role investigates claims, develops action plans, negotiates settlements within designated authority, communicates claim activity with claimants and clients, and reports claims to excess carriers while responding to their requests in a professional and timely manner. The position requires knowledge of Washington or Oregon workers’ compensation jurisdiction and the applicable claims examiner certification. Sedgwick describes a flexible, agile work environment with career development opportunities and a comprehensive benefits package.
Requirements
- High school diploma or GED.
- Five years of claims management experience, or an equivalent combination of education and experience.
- WWCP or Oregon Workers’ Compensation Claims Examiner Certification.
- Knowledge of Washington or Oregon workers’ compensation jurisdiction.
- Ability to think clearly and conceptually, exercise judgment and discretion, troubleshoot, solve problems, analyze information, manage work-related stress and multiple priorities, and meet deadlines.
- Ability to perform computer keyboarding; travel as required.
- Hearing, vision, and talking abilities.
Nice To Haves
- Bachelor’s degree from an accredited college or university.
- Professional certification applicable to the line of business.
Responsibilities
- Analyze and process claims using well-developed action plans to achieve appropriate and timely resolution.
- Investigate claims and gather information to determine claim exposure.
- Negotiate claim settlements within designated authority.
- Communicate claim activity and processing with claimants and clients.
- Report claims to the excess carrier and respond to requests for directions professionally and promptly.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical, dental, and vision benefits.
- 401(k) and matching.
- Paid time off.
- Disability and life insurance.
- Employee assistance program.
- Flexible spending or health savings account.
- Other additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
