Claims Adjuster l Workers Compensation l Portland, OR l Hybrid jobs in United States
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Sedgwick · 18 hours ago

Claims Adjuster l Workers Compensation l Portland, OR l Hybrid

Sedgwick is a global industry leader providing exceptional customer service and support for individuals facing unexpected challenges. The Claims Adjuster role involves analyzing mid- and higher-level workers compensation claims, ensuring proper adjudication, and negotiating settlements.

BankingInsuranceRisk Management

Responsibilities

Manages 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 manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts and approves claim payments
Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract
Manages 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 complex 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 organization's quality program(s)
Travels as required

Qualification

Claims management experienceWorkers compensation knowledgeBachelor's degreeEmpathyAccountabilityInclusionNegotiation skillsCommunication skillsCollaborationGrowth mindset

Required

Four (4) years of claims management experience or equivalent combination of education and experience required

Preferred

Bachelor's degree from an accredited college or university preferred

Benefits

Flexible Work Schedule
Referral Incentive Program
Opportunity to work from home
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1
Medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits

Company

Sedgwick

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Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.

Funding

Current Stage
Late Stage
Total Funding
$1.5B
Key Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired

Leadership Team

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Michael Arbour
Chairman & Chief Executive Officer
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Kalani Reelitz
Global Chief Financial Officer
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Company data provided by crunchbase