Claims Representative - Workers Compensation - Las Vegas NV
Claims Representative - Workers Compensation - Las Vegas NV
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Job Description
Taking care of people is at the heart of everything we do and we start by taking care of you our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. Its an opportunity to do something meaningful each and every day. Its having support for your mental physical financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference who enjoys a challenge and above all if youre someone who cares theres a place for you here. Join us and contribute to Sedgwick being a great place to work.
Great Place to Work
Most Loved Workplace
Forbes BestinState Employer
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- 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 returntowork 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 lowlevel 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
- Performs other duties as assigned.
- Supports the organizations quality program(s).
- Travels as required.
- WORK ENVIRONMENT
- When applicable and appropriate consideration will be given to reasonable accommodations.Mental: Clear and conceptual thinking ability; excellent judgment troubleshooting problem solving analysis and discretion; ability to handle workrelated stress; ability to handle multiple priorities simultaneously; and ability to meet deadlinesPhysical: Computer keyboarding travel as requiredAuditory/Visual: Hearing vision and talkingNOTE: Credit security clearance confirmed via a background credit check is required for this position.
- QUALIFICATIONS
- Ability to meet or exceed Service ExpectationsAbility to work in a team environment
- Good interpersonal skills
- Strong organizational skills
- Analytical and interpretive skills
- PC literate including Microsoft Office products
- Excellent oral and written communication including presentation skills
- Developing knowledge of regulations offsets and deductions disability duration medical management practices and Social Security and Medicare application procedure as applicable to line of business
- Education & LicensingBachelors degree from an accredited college or university preferred.ExperienceTwo 2 years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
Sedgwickis an Equal Opportunity Employer and a DrugFree Workplace.
If youre excited about this role but your experience doesnt 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.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
