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Specialty Risk Services

Account Specialist - Workers' Compensation

CLAIM YOUR FUTURE AS A GREAT PERFORMER!

Specialty Risk Services, (SRS) is a division of Sedgwick Claims Management Services, Inc. (Sedgwick CMS) and is recognized as one of the top third-party claim administrators and risk management services providers in North America. SRS is a fast-paced, dynamic organization providing a wide variety of comprehensive claim and risk management services to medium and large corporations throughout the United States and Canada including 47 Fortune 500 companies. We value providing exceptional customer service and superior claim handling, while providing our employees with the opportunity for growth and advancement. Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."

PRIMARY PURPOSE:
To plan, recommend, reserve and execute the investigation, valuation, disposition and settlement of claims in a manner consistent with best practices, special account instructions and statutory, regulatory and ethical requirements; to manage a caseload of basic to highly complex claims within specified authority level.

ESSENTIAL FUNCTIONS and DUTIES
Obtains necessary information on claimants and clients in order to meet required expectations in a timely, accurate and efficient manner.
Communicates directly with involved parties, including claimant, client and internal team members as appropriate.
Identifies and documents trends and issues in client claim files and recommends corrective action as appropriate.Investigates, evaluates and resolves assigned claims; identifies and initiates specialized services (i.e. subrogation, fraud evaluation, case management, etc) to resolve claims; and participates in file reviews for assigned claims.Assesses the indemnity, medical and expense exposure of assigned claims; works with clients and their legal representatives to manage litigation in conjunction with client requirements.Ensures that state required documentation is issued accurately and in a timely manner in accordance with specific jurisdictional timeframes and guidelines.

ADDITIONAL FUNCTIONS and DUTIES
Performs other duties as assigned.
Supports the organization’s quality program(s).
Travels as required.

QUALIFICATIONS

Education
High School diploma or GED required; college degree preferred. State adjuster licenses required.

Experience
Two (2) years of related experience required.

Skills and Knowledge
Thorough knowledge of medical terminology and ability to interpret medical reports
Thorough legal and jurisdictional knowledge in claim handling
Strong oral and written communication skills
PC literate, including Microsoft Office products
Strong analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Good negotiating skill
Good problem solving skills
Strong decision making skills
Customer service skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

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, may be 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.

Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace


How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/19133853

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Published on Mar 29, 2011
Viewed: 385 times