Current jobs related to Claims Examiner - Canada - Sedgwick
-
Casualty Claims Examiner
1 week ago
Canada Portage Mutual Full timeThe Opportunity: Casualty Claims Examiner As a Casualty Claims Examiner, you'll investigate, evaluate, reserve, negotiate and resolve assigned automobile and commercial general liability injury losses by:Reviewing new claims, developing thorough investigation strategies, securing statements, collecting key documentation (including medical records,...
-
Claims Examiner
2 weeks ago
Canada Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
Claims Examiner
2 weeks ago
Canada Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
Workers Compensation Claims Examiner Remote
2 weeks ago
Canada Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
Claims Supervisor
2 weeks ago
Canada Crawford Full timeDescriptionWe are currently recruiting for a Claims Supervisor to join our team in Canada. The position location is flexible, and we can offer in-office, hybrid or fully remote working arrangements.The successful candidate will supervise adjusters, monitors quality, and assists manager with administrative tasks, strategy implementation and mentoring while...
-
Claims Manager
1 week ago
Portage la Prairie, MB, Canada Portage Mutual Full timeWhat You'll Do:The Claims Manager works with the Director of Claims - Property sharing tasks, supervising the Claims teams and operations including assignment of claims, directing process, maintaining quality control, and providing performance feedback and reviews. They ensure the company's claims plan is met and that the company Policies and procedures are...
-
Sr. Adjuster- Accident Benefits
3 days ago
, , Canada Sedgwick Claims Management Services Ltd Full timeSr. Adjuster- Accident Benefits page is loaded## Sr. Adjuster- Accident Benefitslocations: Canada Telecommutertime type: Full timeposted on: Posted Todayjob requisition id: R68671By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We...
-
, AB, Canada Alberta Blue Cross Full timeReporting, Recovery, and Investigation Officer – Claims Audit & Investigations Services Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. We’re committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. We...
-
, AB, Canada ABC Benefits Corporation Full timeReporting, Recovery, and Investigation Officer – Claims Audit & Investigations Services page is loaded## Reporting, Recovery, and Investigation Officer – Claims Audit & Investigations Serviceslocations: Work From Home: Albertatime type: Full timeposted on: Posted 4 Days Agojob requisition id: R1035Alberta Blue Cross is an Alberta based organization...
-
Workers Compensation Consultant- Level 1
4 weeks ago
, , Canada Sedgwick Full timeJoin to apply for the Workers Compensation Consultant - Level 1 role at Sedgwick . 1 week ago – Be among the first 25 applicants. Get AI-powered advice on this job and more exclusive features. By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the...
Claims Examiner
2 weeks ago
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
Great Place to Work®
Most Loved Workplace®
Forbes Best-in-State Employer
Claims Examiner - Workers Compensation (Remote Opportunity, Must Reside in CA)
- PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
- ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Negotiates settlement of claims within designated authority.
- Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
- Prepares necessary state fillings within statutory limits.
- Manages the litigation process; ensures timely and cost effective claims resolution.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
- Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
- Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
- Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding is correct.
- Refers cases as appropriate to supervisor and management.
- ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
- QUALIFICATION
- Education & Licensing
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
- Experience
Five (5) years of claims management experience or equivalent combination of education and experience required.
- Skills & Knowledge
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
- Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
- Physical: Computer keyboarding, travel as required
- Auditory/Visual: Hearing, vision and talking
- NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
- The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
- #claimsexaminer
- As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in CO, NY, WA, or CA. Actual compensation is influenced by a wide range of factors including but not limited to
