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Claims Examiner II Trainee - Workers' Compensation
at Sedgwick CMS in California
Claims Examiner II Trainee
Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick Claims Management Services, Inc. has a strong commitment to its colleagues and its clients. If you are seeking place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick CMS is the place for you.
As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, “Claim Your Future.”
PRIMARY PURPOSE:
To analyze low and mid-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
1. Adjusts medical-only claims and less complex lost-time workers compensation claims under close supervision.
2. Handles low and mid-level liability and/or physical damage claims under close supervision.
3. Supports other claims examiners and claims supervisors with larger or more complex claims as necessary.
4. Processes workers compensation claims determining compensability and benefits due, monitors reserve accuracy and files necessary documentation with state agency.
5. Communicates claim action/processing with claimant and client.
6. Ensures claim files are properly documented and claims coding is correct.
7. Maintains professional client relationships.
8. Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required.
Experience
Eighteen (18) months of claims industry or related 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
- Strong initiative
-Strong problem solving 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 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.
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/19687731
Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick Claims Management Services, Inc. has a strong commitment to its colleagues and its clients. If you are seeking place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick CMS is the place for you.
As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, “Claim Your Future.”
PRIMARY PURPOSE:
To analyze low and mid-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
1. Adjusts medical-only claims and less complex lost-time workers compensation claims under close supervision.
2. Handles low and mid-level liability and/or physical damage claims under close supervision.
3. Supports other claims examiners and claims supervisors with larger or more complex claims as necessary.
4. Processes workers compensation claims determining compensability and benefits due, monitors reserve accuracy and files necessary documentation with state agency.
5. Communicates claim action/processing with claimant and client.
6. Ensures claim files are properly documented and claims coding is correct.
7. Maintains professional client relationships.
8. Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Licenses as required.
Experience
Eighteen (18) months of claims industry or related 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
- Strong initiative
-Strong problem solving 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 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.
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/19687731
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Published on May 12, 2011
Viewed: 271 times
Viewed: 271 times
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