Claims Adjuster – Workers Compensation (Nevada Residents) Job Vacancy in Sedgwick Las Vegas, NV 89129 – Latest Jobs in Las Vegas, NV 89129

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Company Name : Sedgwick
Location : Las Vegas, NV 89129
Position : Claims Adjuster – Workers Compensation (Nevada Residents)

Job Description : PRIMARY PURPOSE: To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
* Candidates must reside in NV *
BENEFITSCompetitive salaryFlexible work scheduleReferral Incentive ProgramInternal career progression and developmentBenefits eligibility and 401(k) with company match day 1
ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
Develops and manages workers compensation claims’ action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
Manages subrogation of claims and negotiates settlements.
Communicates claim action with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS
Education & Licensing
Bachelor’s degree from an accredited college or university preferred.

Will be expected to obtain Nevada Staff Adjuster License within 3 months of hire.

Experience
Four (4) years of claims management experience or equivalent combination of education and experience required.
Skills & Knowledge

Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure 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 skill
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.
Job Type: Full-time
Pay: From $65,000.00 per year
Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible schedule
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Professional development assistance
Referral program
Retirement plan
Tuition reimbursement
Vision insurance

Physical Setting:

Office

Schedule:

8 hour shift
Monday to Friday

Ability to commute/relocate:

Las Vegas, NV 89129: Reliably commute or planning to relocate before starting work (Required)

Education:

High school or equivalent (Required)

Experience:

Workers’ compensation: 2 years (Required)

License/Certification:

Nevada Staff Adjuster (Preferred)

Work Location: One location

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