Location: Winter Park, FL
Company: Blue Cross Staffing
Insurance jobs refer to careers within the insurance industry, where professionals help individuals and businesses manage risk and financial losses by providing them with insurance products. These roles can range from sales agents who sell policies, underwriters who assess risks and set premiums, claims adjustors who handle the compensation process, to actuaries who analyze statistical data to price insurance products accurately. The sector is known for its stability, opportunities for advancement, and the critical role it plays in personal financial planning and the economic health of society.
Insurance jobs are positions within the insurance industry, where professionals help individuals and businesses manage risk and protect against financial losses. These roles can range from actuaries who analyze data to predict risks, to underwriters who decide what and whom to insure, to claims adjusters who handle the aftermath of an event. Key features include the need for strong analytical abilities, excellent communication skills, and a deep understanding of financial principles and regulations. Working in insurance often requires a balance of technical knowledge and interpersonal skills, with a focus on customer service and problem-solving.
Insurance jobs refer to career opportunities within the insurance industry, where professionals work to assess risks, provide financial protection to individuals and businesses, and offer various types of insurance coverage. Key features of these jobs include risk management, customer service, policy underwriting, claims handling, and potentially sales. Professionals in this field often require strong analytical skills, attention to detail, and excellent communication abilities to explain complex insurance products and assist clients with their insurance needs.
support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve.
If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Claims Representative - IAP WC (Entry Level) Atl,
GA/ Lake Mary, FL/Memphis, TN/Charlotte, NC PRIMARY PURPOSE : To be oriented and trained as new industry professional with the ability to analyze workers compensation, general liability or disability claims and determine benefits due.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES Attendance and completion of designated classroom claims professional training program. Performs on-the-job training activities including: Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. Adjusting low and mid-level liability and/or physical damage claims under close supervision. Processing disability claims of minimal disability duration under close supervision.
Documenting claims files and properly coding claim activity. Communicating claim action/processing with claimant and client.
Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. Participates in rotational assignments to provide temporary support for office needs. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred or equivalent experience as outlined below. Experience No experience required with college degree. State license, self-insured certificate, WCCA/WCCP designation, or completion of the Sedgwick Claims Progression Program required without a degree.
Prior claims experience preferred. Skills and Knowledge Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical 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 is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Requisition #: R44411tcv57hlu2
support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve.
If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Claims Examiner 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.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within
designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s).
Travels as required. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations 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, 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 is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Requisition #: R43982tcv57hlu2