Sedgwick · 3 hours ago

Claims Examiner - Workers Compensation

Tennessee, United States

Full-time

Remote

Entry Level

1+ years exp

Maximize your interview chances

BankingInsurance

Insider Connection @Sedgwick

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.

Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.

Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.

Communicates claim action/processing with claimant, client and appropriate medical contact.

Ensures claim files are properly documented and claims coding is correct.

May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.

Maintains professional client relationships.

Performs other duties as assigned.

Supports the organization's quality program(s).

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Microsoft Office