Claims Adjuster - General Liability (REMOTE - Bodily Injury Exp needed)

Sedgwick Claims Management Services, Inc.

Job Overview

Location

Telecommuter GA

Job Type

Full-time

Full Job Description

📋 Description

• Analyze mid- and higher-level workers compensation claims to determine benefits due; ensure ongoing adjudication of claims within company standards and industry best practices; identify subrogation of claims and negotiate settlements.
• Manage workers compensation claims determining compensability and benefits due on long term indemnity claims, monitor reserve accuracy, and file necessary documentation with state agency.
• Develop and manage workers compensation claims action plans to resolution, coordinate return-to-work efforts, and approve claim payments.
• Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract.
• Manage subrogation of claims and negotiate settlements.
• Communicate claim action with claimant and client.
• Ensure claim files are properly documented and claims coding is correct.
• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintain professional client relationships.

🎯 Requirements

• Bachelor’s degree from an accredited college or university preferred.
• 3-4 years of Workers Compensation claims management experience or equivalent combination of education and experience required.

🏖️ Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Skills & Technologies

Remote

Degree Required

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Sedgwick Claims Management Services, Inc.

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About Sedgwick Claims Management Services, Inc.

Sedgwick is a global provider of technology-enabled risk, benefits and integrated business solutions, primarily handling insurance claims, managed care, absence and disability, and productivity management for employers, carriers, and administrators. The company processes millions of claims annually across workers' compensation, property, casualty, disability, and other lines, leveraging analytics and digital platforms to improve outcomes, reduce costs, and enhance customer and employee experiences.

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