Claims Recovery Representative

Sedgwick Claims Management Services, Inc. Sun Prairie , WI 53591

Posted 2 weeks ago

Claims Recovery Representative

IF YOU CARE, THERE'S A PLACE FOR YOU HERE

For a career path that is both challenging and rewarding, join Sedgwick's talented team of 21,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets -- their employees, their customers and their property. At Sedgwick, caring counts. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.

PRIMARY PURPOSE: To identify and pursue potential Second Injury Fund and subrogation recoveries associated with workers compensation claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Reviews workers compensation claims to determine if potential for Second Injury Fund recoveries exist.

  • Pursues medical information necessary to qualify claim for acceptance by the Second Injury Fund.

  • Pursues information necessary to satisfy the Second Injury Fund's knowledge requirement.

  • Determines from knowledge and medical information secured whether to submit claim warrants to Second Injury Fund for acceptance.

  • Approves and/or pays bills as appropriate.

  • Reviews workers' claims and conducts investigations to determine if potential for subrogation exists.

  • Gathers information necessary to support viable subrogation claim.

  • Notifies appropriate parties of subrogation lien.

  • Secures recovery from responsible parties.

  • Prepares various type status reports for clients.

  • Enters recoveries into the claims management system.

  • Obtains settlement authority from state funds and negotiates compromise settlements with state funds.

ADDITIONAL FUCNTIONS 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.

Experience

Three (3) years of claims experience or equivalent combination of education and experience required.

Skills & Knowledge

  • Thorough knowledge of claims management processes and procedures

  • Excellent oral and written communication

  • PC literate, including Microsoft Office products

  • Strong organizational skills

  • Excellent interpersonal 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

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


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Claims Recovery Representative

Sedgwick Claims Management Services, Inc.