Claims Representative - Workers Compensation | Jurisdiction: IL, IN, KS, MI, MO, NE, WI and MN | Licensing: Required

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

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Claims Representative - Workers Compensation | Jurisdiction: IL, IN, KS, MI, MO, NE, WI and MN | Licensing: Required

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

• A stable and consistent work environment in an office setting

• A training program to learn how to help employees and customers from some of the world’s most reputable brands

• An assigned mentor and manager who will guide you on your career journey

• Career development and promotional growth opportunities through increasing responsibilities

• A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs

PRIMARY PURPOSE OF THE ROLE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.

• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

• Administers subrogation of claims and negotiates settlements.

• Communicates claim action with claimant and client.

• Ensures claim files are properly documented and claims coding is correct.

• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

• Maintains professional client relationships. 

QUALIFICATIONS

Education & Licensing: 2 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.

Jurisdiction Knowledge:  IL, IN, KS, MI, MO, NE, WI and MN

Licensing: Required

TAKING CARE OF YOU

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.

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.