Claims Representative - Workers Compensation (Remote) - Dedicated Account

Sedgwick • Hartford, CT

400d • Remote

About The Position

The Claims Representative for Workers Compensation at Sedgwick is responsible for analyzing complex workers' compensation claims, ensuring timely adjudication, and managing high exposure claims involving litigation and rehabilitation. This remote position emphasizes a culture of caring, flexibility, and support for professional growth, while also focusing on making a positive impact through effective claims management.

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.
• Subject matter expert in insurance principles and laws relevant to the line of business.
• Excellent oral and written communication skills, including presentation skills.
• PC literate, including proficiency in Microsoft Office products.
• Strong analytical and interpretive skills.
• Strong organizational skills and good interpersonal skills.
• Excellent negotiation skills and ability to work in a team environment.
• Ability to meet or exceed service expectations.

Nice To Haves

• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyze and process complex workers' compensation claims by investigating and gathering information to determine exposure.
• Negotiate settlement of claims within designated authority.
• Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the claim's life.
• Calculate and pay benefits due; approve and make timely claim payments and adjustments.
• Prepare necessary state filings within statutory limits.
• Manage the litigation process; ensure timely and cost-effective claims resolution.
• Coordinate vendor referrals for additional investigation and/or litigation management.
• Use appropriate cost containment techniques to reduce overall claims costs for clients.
• Manage claim recoveries, including subrogation and offsets.
• Report claims to the excess carrier and respond to requests in a professional manner.
• Communicate claim activity and processing with claimants and clients; maintain professional relationships.
• Ensure claim files are properly documented and claims coding is correct.
• Refer cases as appropriate to supervisor and management.

Benefits

• Flexible work environment
• Support for mental, physical, financial, and professional needs
• Opportunities for career growth and skill sharpening
• Diversity and inclusion initiatives

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 10,001+ employees