Workers Compensation Claims Representative | Medical Only VA Jurisdiction | Dedicated Client

Sedgwick Claims Management Services, Inc.

Job Overview

Location

Telecommuter VA

Job Type

Full-time

Full Job Description

📋 Description

• Process low-level workers' compensation claims in Virginia Medical Only jurisdiction, determining compensability and benefits due on long-term indemnity claims, monitoring reserve accuracy, and maintaining necessary documentation with the state agency.
• Develop and coordinate action plans for resolution, return-to-work efforts, and approving claim payments for low-level workers' compensation claims.
• Administer subrogation of claims and negotiate settlements.
• Communicate claim actions with claimants and clients.
• Ensure 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.
• Maintain professional client relationships.

🎯 Requirements

• 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.

🏖️ Benefits

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

Skills & Technologies

Onsite

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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