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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and managing workers compensation claims, ensuring timely resolution and adherence to industry best practices. Proficient in negotiation, communication, and problem-solving within the claims management process.
Highest-signal resume keywords
Claims Management ExperienceNegotiation SkillsJurisdiction Knowledge: MD and NJProfessional CertificationClear and Conceptual Thinking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AnalysisClaims ProcessingAdjudicationInformation GatheringSettlement NegotiationComputer Keyboarding
Soft Skills
Excellent JudgmentProblem SolvingDiscretionAbility to Handle Work-Related StressAbility to Meet Deadlines
Certifications & Qualifications
Professional CertificationHome State Licensing
Industry Keywords
Workers CompensationClaims AdjudicationClient Service RequirementsAction PlansExcess Carrier Reporting
About the role
Key responsibilities & impact- Analyze workers compensation claims on behalf of clients to determine benefits due
- Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
- Analyze and process claims through action plans to timely resolution
- Investigate and gather information to determine claim exposure
- Negotiate claim settlements within designated authority
- Communicate claim activity and processing with claimants and clients
- Report claims to the excess carrier
- Respond to requests for directions professionally and timely
- Work with autonomy in daily work, location, and career path
Requirements
What you’ll need- High School Diploma or GED required
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- 5 years of claims management experience or equivalent combination of education and experience required
- Home state licensing preferred
- Jurisdiction knowledge: MD and NJ
- 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
- Ability to meet deadlines
- Computer keyboarding
- Travel as required
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities
- Medical, dental, vision, 401K on day one
- 401k and matching
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
- Flexible work arrangement: 2 days in office and 3 days work from home within 25 miles of a Sedgwick office; fully remote considered outside the radius