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The Claims Adjuster position is responsible for the investigation, negotiation, evaluation, disposition and settlement of semi-complex claims and moderate exposures on non-traditional claims products.
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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.
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Study Strat egy: Clinical Study Leader (CSL) or Major Scientific/Medical Contributor; For large or complex Phase 2 Studies: Provides the strategic direction to BDO for EDC, edit checks, data quality listings, SAP, DM plan, Reviews patient population and protocol compliance for consistency with study strategy, develops biomarker strategy in collaboration with TMCP, collaborates with external KOLs to refine study plans; Prepares and participate in regulatory agency meetings, if applicable.
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PRIMARY PURPOSE: To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
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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.
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To analyze Liability Claims Examiner claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
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Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Liability Claims Examiner | Remote. 5 years of liability claims management experience required.
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Provides technical/jurisdictional direction to examiner reports on claims adjudication. Provides technical/jurisdictional direction to examiner reports on claims adjudication. Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
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At least 3 years of injury litigation experience in Auto, General Liability or Product Liability required. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
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Develops a pro-active, positive labour relations environment within a safe and harassment free workplace assisting in the adjudication of first and second stage grievances, participating in arbitrations.
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Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (60,000 - 75,000.
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Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions.
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Medicare Part D - PBM or claim adjudication knowledge. Highly desired Excel skills include ability to manage and present large volumes of data, creating/using complex formulas, report formatting, pivot tables, data manipulation, and other advanced functions.
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Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner. Claims Team Lead - Workers Compensation REMOTE. Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
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