Workers' Compensation Consultant

Join to apply for the Workers' Compensation Consultant role at Sedgwick . 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 unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation. 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. Sedgwick retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer. PRIMARY PURPOSE : To manage worker compensation claims on behalf of clients and to function as a client advocate before Provincial Worker Compensation Boards. Analyze complex or technically difficult workers' compensation claims. Ensure ongoing management of claims within service expectations, industry best practices and specific client service requirements; and to identify cost saving opportunities bring claims to resolution. 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. Review decisions made by Provincial Worker Compensation Boards and determine if decisions are appropriate and within the legislation. Provide claim analysis to client to determine if decisions require formal appeal. 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. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. Provide analysis of financial / loss experience / premium data to assist in reducing claim cost for clients. ADDITIONAL FUNCTIONS AND RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. Assist in account management / facilitate client stewardship meetings. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Minimum 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. Knowledge of legislation of Provincial WC Boards 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 Sedgwick is an Equal Opportunity Employer. #J-18808-Ljbffr