Claims Examiner I, Workers' Compensation - Charleston, WV – CHA00106

Description

CLAIM YOUR FUTURE AS A GREAT PERFORMER!

Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities.  We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment.  We are proud to have been recently voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice® designation.  Come be a part of our team and 'Claim Your Future.'

PRIMARY PURPOSE: To analyze reported lower-level workers' compensation claims to determine benefits due and to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

1. Adjusts medical-only claims and minor lost-time workers' compensation claims under close supervision
2. Assists other claims examiners and claims supervisors with larger or more complex claims as necessary
3. Processes workers' compensation claims determining compensability and benefits due, monitors reserve accuracy and files necessary documentation with state agency
4. Communicates claim action/processing with claimant and client. Maintains professional client relationships
5. Supports the Total Performance Management initiative

• High school diploma or GED required
• Licenses as required

Experience: One (1) year of claims industry experience, preferably workers' compensation, required

Skills & Knowledge:

• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies