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Sedgwick
Sedgwick
H1B vizasi homiysiKonsaltingQurilishSog‘liqni saqlash
Sedgwick butun dunyo bo‘ylab tashkilotlarga texnologiyaga asoslangan xatarlarni boshqarish, xodimlar imtiyozlari va integratsiyalashgan biznes yechimlarini taqdim etadi. Kompaniya baxtsiz hodisa, sog‘liq, mehnatga layoqatsizlik, ishsizlik kompensatsiyasi va javobgarlik bo‘yicha da’volarni boshqarish bilan birga, konsalting, sud-buxgalteriya ekspertizasi, sud-muhandislik ekspertizasi, mulkni tiklash, brendni himoya qilish va yo‘qotishlarning oldini olish xizmatlarini rivojlantiradi. Sedgwick qurilish, konsalting, sog‘liqni saqlash, qishloq xo‘jaligi va atrof-muhit xizmatlari kabi sohalardagi mijozlarni qo‘llab-quvvatlaydi hamda xilma-xillik, tenglik, inklyuzivlik va ekologik, ijtimoiy hamda korporativ boshqaruv amaliyotlariga e’tibor qaratishini bildiradi.
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Kompaniyadagi ish o‘rinlari

Sedgwick Workers' Compensation Claims Examiner, California Remote

Sedgwick seeks a California-based workers' compensation claims examiner to manage complex claims from investigation through resolution. The role covers litigation, settlements, reserves, payments, recoveries, and client communication.

USAmerika Qo‘shma ShtatlariCAKaliforniya
80 000 $ – 100 000 $ / yil
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaSug‘urta da’volari bo‘yicha mutaxassis

Tavsif

  • Evaluate complex workers' compensation claims and determine payable benefits
  • Investigate claims and collect information to assess exposure
  • Drive claims to timely, appropriate resolution through documented action plans
  • Negotiate settlements within delegated authority
  • Set and monitor reserves throughout the claim lifecycle
  • Calculate and issue benefits, approve payment adjustments, and settle claims within authority
  • Complete required state filings within statutory deadlines
  • Oversee litigation for timely and cost-effective outcomes
  • Coordinate vendors supporting investigations and litigation
  • Use cost-containment methods and strategic vendor relationships
  • Manage recoveries involving subrogation, Second Injury Fund excess claims, and Social Security and Medicare offsets
  • Report claims to excess carriers and address requests for direction
  • Explain claim activity and processing to claimants and clients
  • Build and maintain professional client relationships
  • Keep claim files complete and ensure accurate claims coding
  • Escalate appropriate cases to supervisors and management

Talablar

  • At least five years of claims management experience, or an equivalent combination of education and experience
  • Knowledge of California claims jurisdiction and regulations
  • SIP certification, or the ability to obtain it within one year of employment
  • Bachelor's degree from an accredited college or university preferred
  • Relevant professional certification preferred where applicable to the business line
  • Capability to evaluate and process complex or technically challenging workers' compensation claims
  • Working knowledge of claims investigation, reserves, benefit payments, settlements, litigation, subrogation, recoveries, and cost containment
  • Ability to complete required state filings within statutory deadlines
  • Ability to oversee claims and litigation processes
  • Professional communication skills for working with claimants and clients
  • Ability to maintain complete claim documentation and accurate coding

Imtiyozlar

  • Flexible scheduling
  • Employee referral incentive program
  • Career development and advancement opportunities
  • Medical, dental, and vision coverage
  • 401(k) plan with matching
  • Paid time off
  • Disability and life insurance coverage
  • Employee assistance program
  • Flexible spending account or health savings account
  • Additional voluntary benefits
  • Support for work-life balance
  • Professional development opportunities
  • Flexibility and autonomy over daily work, location, and career direction

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